Background
Methods
Population and baseline assessment
CFVR measurement and analysis
MBFR measurement and analysis
CMR
CMR analysis
Statistical analyses
Results
Study population
CFVR population, n = 64 | MBFR population, n = 54 | |
---|---|---|
Age, mean (SD) | 62.5 (8.3) | 62.0 (7.5) |
Hypertension, n (%) | 38 (59.4) | 29 (53.7) |
Hyperlipidaemia, n (%) | 42 (65.6) | 34 (63) |
Family history of CAD, n (%) | 36 (57.1) | 30 (57) |
Smoking (current), n (%) | 15 (23) | 12 (22) |
Smoking (previous + current), n (%) | 39 (61) | 34 (63) |
Pack years (20 cig./day) · year)a, median (IQR) | 27 (7;35) | 29 (8;35) |
Stable angina pectoris, n (%) | 45 (70.3) | 39 (72) |
Postmenopausal status, n (%) | 56 (89) | 48 (89) |
Comorbidity, n (%) | 38 (60) | 31 (59) |
ESC’s HeartScore (% risk)b, mean (SD) | 1.4 (1.2) | 1.3 (1.3) |
Framingham risk scorec, mean (SD) | 0.093 (0.05) | 0.094 (0.06) |
Biochemistry | ||
Total-cholesterol (mmol/l), mean (SD) | 4.8 (1.0) | 4.9 (1.1) |
LDL cholesterol (mmol/l), mean (SD) | 2.7 (1.0) | 2.8 (1.0) |
HDL cholesterol (mmol/l), mean (SD) | 1.6 (0.5) | 1.6 (0.5) |
Non-HDL cholesterol (mmol/l), mean (SD) | 3.2 (1.0) | 3.3 (1.0) |
Hematocrit, mean (SD) | 40.5 (2.9) | 40.7 (2.7) |
Clinical Assessment | ||
Body mass index (kg/m2), median (IQR) | 23.9 (21.9;28.3) | 23.7 (22.0;27.9) |
Body mass index (kg/m2) > 25, n (%) | 26 (41) | 22 (40) |
Abdominal circumference (cm), mean (SD) | 93.5 (12.4) | 93 (12.5) |
Systolic blood pressure (mmHg), mean (SD) | 148.1 (25.7) | 146.5 (25.8) |
Diastolic blood pressure (mmHg), mean (SD) | 85.5 (15.8) | 85.6 (16.5) |
Heart rate at rest (bpm), mean (SD) | 64.8 (10.3) | 64.2 (11.1) |
Atherosclerosis at CAG, n (%) | 29 (45) | 24 (44) |
Cardiac Magnetic Resonance (global values) | ||
Left ventricular ejection fraction (%), mean (SD) | 59.6 (5.9) | 59.7 (5.9) |
End systolic volume (ml), mean (SD) | 60.6 (17.2) | 61.1 (17.4) |
End diastolic volume (ml), mean (SD) | 148.5 (27.0) | 150.3 (27.8) |
Left ventricular mass index (g/m2), mean (SD) | 48.38 (7.6) | 49.1 /7.8) |
Left ventricular hypertrophy, n (%) | 5 (8) | 5 (10) |
Cardiac output, mean (SD) | 5.7 (1.1) | 5.7 (1.2) |
Stroke volume, mean (SD) | 87.9 (15.3) | 89.3 (16.1) |
Myocardial mass (diastole), mean (SD) | 87.2 (17.8) | 88.2 (18.8) |
Myocardial mass (systole), mean (SD) | 92.6 (20.7) | 92.9 (21.5) |
Medication | ||
Beta Blockers, n (%) | 23 (36) | 19 (35) |
Acetylsalicylic acid, n (%) | 35 (54.7) | 29 (54) |
Statin, n (%) | 35 (54.7) | 28 (52) |
Calcium antagonists, n (%) | 17 (27) | 13 (25) |
Angiotensin conv. enzyme inhibitor, n (%) | 8 (13) | 7 (13) |
Angiotensin receptor blockers, n (%) | 11 (18) | 6 (11) |
Measures of diffuse myocardial fibrosis and cardiovascular risk factors
Ventricular Slice | Coronary Artery Territory | |||||||
---|---|---|---|---|---|---|---|---|
Basal | Mid | Apical |
p-value* | LAD | RCA | LCX |
p-value* | |
T1 native (ms) | 1043 (38) | 1016 (57) | 976 (117) | <0.0001 | 992 (48) | 1023 (39) | 955 (82) | <0.0001 |
T1 postcontrast (ms) | 483 (35) | 469 (38) | 439 (35) | <0.0001 | 464 (37) | 459 (64) | 477 (40) | 0.10 |
ECV (%) | 32.8 (3.3) | 33.1 (4.0) | 34.6 (5.0) | 0.04 | 32.0 (3.0) | 32.1 (3.5) | 30.2 (4.0) | 0.001 |
Extracellular Volume Fraction (%) | Native T1 (ms) | |||||||
---|---|---|---|---|---|---|---|---|
<32.3 | 32.3-34.5 | >34.5 |
p-value* | <996 | 996-1032 | T > 1032 |
p-value* | |
(n = 22) | (n = 21) | (n = 21) | (n = 22) | (n = 21) | (n = 21) | |||
T1 native (ms)/ECV (%), mean (SD) | 996 (49) | 1010 (37) | 1065 (129) | <0.001**
| 32.5 (3.2) | 33.04 (1.8) | 35.6 (4.9) | <0.001**
|
CFVR, median (IQR) | 2.2 (1.9;2.6) | 2.6 (2.1;2.9) | 2.1 (1.7;2.6) | 0.27**
| 2.2 (1.7;2.6) | 2.5 (2.0;2.9) | 2.2 (1.8;2.6) | 0.61**
|
MBFRa, median (IQR) | 2.7 (2.1;2.9) | 2.7 (2.2;3.3) | 2.7 (2.3;3.0) | 0.13**
| 2.6 (2.0;2.9) | 2.8 (2.6;3.2) | 2.5 (2.1;2.7) | 0.64**
|
Age (years), mean (SD) | 63.5 (7.9) | 60.2 (7.8) | 63.6 (9.1) | 0.31 | 64.3 (8.2) | 61.5 (8.0) | 61.5 (8.8) | 0.45 |
BMI (kg/m2), median (IQR) | 25 (23;29) | 23 (22;26) | 23 (22;29) | 0.31 | 24 (22;28) | 24 (22;26) | 25 (22;29) | 0.86 |
Hypertension, n (%) | 15 (68) | 12 (57) | 11 (52) | 0.56 | 18 (82) | 7 (33) | 13 (62) | 0.01 |
Smoking (current), n (%) | 3 (14) | 6 (29) | 6 (29) | 0.42 | 4 (18) | 3 (14) | 8 (38) | 0.16 |
Ever smoked, n (%) | 17 (77) | 11 (52) | 11 (52) | 0.17 | 13 (59) | 12 (57) | 14 (67) | 0.80 |
Atherosclerosis on CAG, n (%) | 16 (73) | 6 (29) | 7 (33) | 0.01 | 11 (50) | 7 (33) | 11 (52) | 0.41 |
Non-HDL cholesterol, mean (SD) | 3.3 (1) | 3.2 (0.9) | 3.2 (1.2) | 0.84 | 3.0 (1.1) | 3.5 (1.0) | 3.3 (0.7) | 0.24 |
Systolic BP (mmHg), mean (SD) | 152 (21) | 146 (27) | 147 (29) | 0.71 | 146 (22) | 146 (26) | 152 (30) | 0.67 |
Resting HR (bpm), mean (SD) | 65 (9.5) | 63 (11.8) | 67 (9.6) | 0.53 | 65 (11.2) | 60 (11.3) | 69 (6.5) | 0.04 |
Ejection fraction (%), mean (SD) | 61 (5.2) | 60 (6.7) | 59 (5.9) | 0.46 | 60.9 (4.9) | 59.4 (5.7) | 58.7 (7.1) | 0.48 |
LV mass index (g/m2), mean (SD) | 47.9 (6.5) | 48.4 (6.6) | 48.8 (9.7) | 0.94 | 46.6 (5.5) | 50.3 (8.7) | 48.4 (8.3) | 0.31 |
LV hypertrophy, n (%) | 1 (5) | 1 (5) | 3 (14) | 0.44 | 0 (0) | 3 (14) | 2 (10) | 0.84 |
ESC HeartScore (% risk)b, mean (SD) | 1.64 (1.3) | 1.00 (1.2) | 1.4 (1.1) | 0.23 | 1.5 (1.1) | 1.05 (1.3) | 1.5 (1.2) | 0.37 |
Framingham risk scorec, mean (SD) | 0.1 (0.06) | 0.08 (0.04) | 0.1 (0.06) | 0.35 | 0.09 (0.05) | 0.1 (0.06) | 0.09 (0.06) | 0.90 |
Beta blockers, n (%) | 9 (41) | 9 (43) | 5 (24) | 0.38 | 10 (45) | 8 (38) | 5 (24) | 0.34 |
Acetylsalicylic acid, n (%) | 13 (59) | 12 (57) | 10 (48) | 0.73 | 13 (59) | 10 (48) | 12 (57) | 0.73 |
Statin, n (%) | 15 (68) | 13 (62) | 7 (33) | 0.06 | 15 (68) | 10 (48) | 10 (48) | 0.30 |
Calcium antagonists, n (%) | 7 (32) | 6 (29) | 4 (19) | 0.61 | 8 (36) | 3 (14) | 6 (29) | 0.31 |
ACE inhibitor, n (%) | 2 (9) | 3 (14) | 3 (14) | 0.82 | 5 (23) | 1 (5) | 2 (10) | 0.24 |
Ang.Rec. Blockers, n (%) | 3 (14) | 3 (14) | 5 (25) | 0.65 | 4 (18) | 2 (10) | 5 (24) | 0.52 |
Measures of coronary microvascular dysfunction and cardiovascular risk factors
Coronary Flow Velocity Reserve | Myocardial Blood Flow Reserve | |||||||
---|---|---|---|---|---|---|---|---|
<2 | 2-2.5 | >2.5 |
p-value* | <2 | 2-2.5 | >2.5 |
p-value* | |
(n = 23) | (n = 16) | (n = 25) | (n = 6) | (n = 13) | (n = 35) | |||
MBFR/CFVR, median (IQR) | 2.2 (2.0;2.7) | 2.7 (2.4;2.8) | 2.9 (2.5;3.2) | 0.01**
| 2.4 (1.9;2.7) | 2.0 (1.7;2.3) | 2.6 (2.2;2.9) | 0.01**
|
T1 native (ms), mean (SD) | 1046 (123) | 1005 (123) | 1014 (51) | 0.61**
| 985 (34) | 1053 (159) | 1013 (55) | 0.64**
|
ECV (%), mean (SD) | 34.5 (4.5) | 32.6 (2.2) | 33.7 (2.9) | 0.27**
| 31.2 (2.7) | 34.2 (3.9) | 33.6 (2.6) | 0.13**
|
Age (years), mean (SD) | 64.0 (10.3) | 61.2 (6.4) | 61.8 (7.49 | 0.52 | 60.2 (7.5) | 63.1 (8.6) | 61.9 (7.2) | 0.74 |
BMI (kg/m2), median (IQR) | 24 (22;27) | 23 (21;28) | 25 (23;29) | 0.42 | 26 (24;29) | 23 (22;24) | 25 (22;29) | 0.46 |
Hypertension, n (%) | 20 (89) | 10 (63) | 8 (32) | 0.002 | 5 (83) | 10 (77) | 14 (40) | 0.03 |
Smoking (current), n (%) | 6 (26) | 4 (25) | 5 (20) | 0.87 | 3 (50) | 4 (31) | 5 (14) | 0.13 |
Ever smoked, n (%) | 14 (61) | 14 (88) | 11 (44) | 0.04 | 5 (83) | 10 (77) | 19 (54) | 0.22 |
Atherosclerosis on CAG, n (%) | 12 (52) | 10 (63) | 7 (28) | 0.08 | 5 (83) | 5 (39) | 14 (40) | 0.20 |
Non-HDL cholesterol, mean (SD) | 3.2 (1.0) | 3.0 (0.9) | 3.5 (1.0) | 0.36 | 3.0 (1.2) | 3.5 (0.8) | 3.2 (1.1) | 0.59 |
Systolic BP (mmHg), mean (SD) | 142 (24) | 156 (22) | 149 (28) | 0.28 | 151 (18) | 141 (30) | 148 (26) | 0.68 |
Resting HR (bpm), mean (SD) | 68 (10) | 68 (12) | 60 (9) | 0.02 | 68 (15) | 70 (9) | 61 (104) | 0.05 |
Ejection fraction (%), mean (SD) | 58.6 (6.7) | 61.7 (4.2) | 59.4 (6.0) | 0.30 | 57.6 (10.0) | 58.6 (6.1) | 60.6 (4.9) | 0.39 |
LV mass index (g/m2), mean (SD) | 45.8 (6.0) | 49.7 (8.2) | 50.1 (8.2) | 0.12 | 49.4 (2.3) | 47.3 (9.8) | 49.9 (7.7) | 0.61 |
LV hypertrophy, n (%) | 0 (0) | 2 (15) | 3 (12) | 0.96 | 0 (0) | 1 (8) | 4 (11) | 0.90 |
ESC HeartScore (% risk)a, mean (SD) | 1.3 (1.0) | 1.4 (1.2) | 1.3 (1.5) | 0.91 | 1.2 (0.8) | 1.6 (1.4) | 1.2 (1.2) | 0.59 |
Framingham risk scoreb, mean (SD) | 0.09 (0.04) | 0.1 (0.06) | 0.09 (0.06) | 0.61 | 0.1 (0.1) | 0.08 (0.03) | 0.09 (0.05) | 0.67 |
Beta blockers, n (%) | 7 (30) | 6 (38) | 10 (40) | 0.78 | 1 (17) | 5 (38) | 13 (37) | 0.62 |
Acetylsalicylic acid, n (%) | 14 (61) | 7 (44) | 14 (56) | 0.57 | 6 (100) | 6 (46) | 17 (49) | 0.10 |
Statin, n (%) | 15 (65) | 9 (56) | 11 (44) | 0.34 | 6 (100) | 5 (38) | 17 (48.6) | 0.82 |
Calcium antagonists, n (%) | 8 (35) | 3 (19) | 6 (25) | 0.53 | 3 (50) | 3 (23) | 7 (21) | 0.34 |
ACE inhibitor, n (%) | 2 (9) | 4 (25) | 2 (8) | 0.26 | 1 (17) | 2 (15) | 4 (12) | 0.92 |
Ang. Rec. Blockers, n (%) | 7 (30) | 2 (13) | 2 (8) | 0.14 | 0 (0) | 2 (15) | 4 (12) | 0.95 |