In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

High aortic stiffness and myocardial ischemia in non-obstructive coronary artery disease (the MicroCAD project)

Session Poster Session 4

Speaker Mai Tone Lonnebakken

Congress : ESC Congress 2018

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease : Noninvasive Diagnostic Methods
  • Session type : Poster Session
  • FP Number : P3652

Authors : M T Lonnebakken (Bergen,NO), I Eskerud (Bergen,NO), TH Larsen (Bergen,NO), H Midtbo (Bergen,NO), MV Kokorina (Bergen,NO), E Gerdts (Bergen,NO)

Authors:
M.T. Lonnebakken1 , I. Eskerud2 , T.H. Larsen1 , H. Midtbo3 , M.V. Kokorina1 , E. Gerdts2 , 1Haukeland University Hospital and University of Bergen - Bergen - Norway , 2University of Bergen, Department of Clinical Science - Bergen - Norway , 3Haukeland University Hospital, Department of Heart Disease - Bergen - Norway ,

Citation:
European Heart Journal ( 2018 ) 39 ( Supplement ), 759

Background: High aortic stiffness may reduce myocardial perfusion pressure and contribute to development of myocardial ischemia. Whether high aortic stiffness is associated with myocardial ischemia in patients with stable angina and non-obstructive coronary artery disease (CAD) is less explored.

Purpose: Assess if high aortic stiffness is associated with myocardial ischemia in patients with stable angina and non-obstructive CAD.

Methods: We assessed aortic stiffness as carotid-femoral pulse wave velocity (PWV) by applanation tonometry in 125 patients (62±8 years, 58% women) with stable angina and non-obstructive CAD participating in the Myocardial Ischemia in Non-obstructive CAD (MicroCAD) project. Non-obstructive CAD and coronary calcium score were assessed by coronary computer tomography angiography. Patients were grouped in PWV tertiles, and the highest tertile (>8.7 m/s) was taken as high aortic stiffness. Stress induced myocardial ischemia was detected as delayed contrast replenishment by myocardial contrast stress echocardiography. The number of left ventricular (LV) segments with delayed contrast replenishment was regarded as the extent of ischemia.

Results: Patients with high aortic stiffness were older with higher LV mass index and lower prevalence of obesity (all p<0.05), while there were no difference in symptoms, sex, prevalence of hypertension, diabetes, smoking, lipid profile, LV ejection fraction or coronary artery calcium score. Stress induced myocardial ischemia was more common (46% vs. 19%, p=0.001) and the extent of ischemia was larger (4±3 vs. 2±3 LV segments, p=0.005) in patients with high aortic stiffness. In multivariable logistic regression analysis, high aortic stiffness was associated with stress induced myocardial ischemia independent of age, LV mass index and obesity (Table).

Conclusions: In patients with stable angina and non-obstructive CAD, high aortic stiffness was associated with stress induced myocardial ischemia. This suggests that assessment of aortic stiffness may add to the diagnostic evaluation in patients with non-obstructive CAD.

Table 1. Covariables of stress induced myocardial ischemia in multivariable logistic regression analysis
Odds ratio95% Confidence intervalp-value
High aortic stiffness3.411.36–8.550.009
Age (years)1.020.97–1.070.504
Left ventricular mass index (g/m2)1.051.00–1.100.037
Obesity2.500.97–6.420.057

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members



Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are