Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction

Open Heart. 2019 Feb 2;6(1):e000870. doi: 10.1136/openhrt-2018-000870. eCollection 2019.

Coronary endothelial function testing may improve long-term quality of life in subjects with microvascular coronary endothelial dysfunction.

Reriani M1,2, Flammer AJ1, Duhé J1, Li J1, Gulati R1, Rihal CS1, Lennon R3, Tilford JM1, Prasad A1, Lerman LO4, Lerman A1.

Author information

1
Division of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
2
Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
3
Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
4
Division of Nephrology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.

Abstract

AIM:

Angina pectoris in the absence of obstructive coronary artery disease (CAD) is common and is associated with poor quality of life (QOL). Coronary microvascular endothelial dysfunction is associated with myocardial ischaemia and is a common cause of angina. We hypothesise that evaluation of coronary endothelial function, its diagnosis and treatment will favourably impact QOL in patients with angina symptoms and non-obstructive CAD.

METHODS AND RESULTS:

Follow-up was done on 457 patients with chest pain and non-obstructive coronary arteries who had undergone coronary vascular reactivity evaluation by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4±4.7 years, QOL was assessed by administration of the SF-36 QOL survey. Patients diagnosed and treated for microvascular endothelial dysfunction had a higher (better) overall mental composite score (44.8 vs 40.9, p=0.036) and mental health score (44.2 vs 40.7, p=0.047), and a trend towards higher vitality scores (39.1 vs 35.9, p=0.053) and role emotional scores (43.6 vs 40.4, p=0.073), compared with patients with normal endothelial function.

CONCLUSION:

Among patients with chest pain and normal coronaries, diagnosis and treatment of coronary microvascular endothelial dysfunction in those with angina pectoris and non-obstructive CAD are associated with better QOL compared with patients with normal endothelial function.

KEYWORDS:

angina; microvascular endothelial function; quality of life

Full-text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361373/

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