Abstract
BackgroundEndothelial dysfunction may play a key role in non-obstructive coronary artery atherosclerosis. Our study aimed to evaluate the vascular endothelial function and its influencing factors in patients with non-obstructive coronary artery atherosclerosis.MethodsA total of 131 consecutive patients with non-obstructive coronary artery atherosclerosis were enrolled. Flow-mediated dilatation (FMD) was measured at baseline and 1-year follow-up. Endothelial progenitor cells (EPCs) were counted by staining the fasting venous blood with antibodies against CD34 and vascular endothelial growth factor receptor 2.ResultsSystolic blood pressure, pulse pressure and the levels of HbA1c in participants with baseline FMD < 6% (n = 65) were significantly higher than those with baseline FMD ≥ 6% (n = 66). Baseline FMD was negatively associated with EPC counts (r = − 0.199, P < 0.05) and systolic blood pressure (r = − 0.315, P < 0.01). The 1-year FMD was significantly increased compared to the baseline FMD [(9.31 ± 5.62) % vs (7.31 ± 5.26) %, P < 0.001]. Independent predictors of FMD improvement included elevated EPC counts (OR = 1.104, 95% CI: 1.047–1.165, P < 0.001) and decreased levels of serum creatinine (OR = 0.915, 95% CI: 0.843–0.993, P = 0.034).ConclusionsFamily history of premature cardiovascular diseases, hypertension, elevated systolic pressure, and HbA1c > 6.5% are independent risk factors for endothelial dysfunction in non-obstructive atherosclerotic patients. Elevated peripheral blood EPC counts and decreased levels of serum creatinine are independent predictors of endothelial function improvement.
Highlights
Non-obstructive coronary artery atherosclerosis is characterized by coronary artery stenosis less than 50% [1,2,3]
No significant difference in inflammatory biomarkers and CD34 + vascular endothelial growth factor receptor 2 (VEGFR2)+ Endothelial progenitor cells (EPCs) counts was found between patients with flowmediated dilatation (FMD) < 6% and those with FMD ≥ 6% (Table 2)
Our study found that systolic blood pressure and pulse pressure were significantly higher in the participants with FMD < 6% than those with FMD ≥ 6%
Summary
Non-obstructive coronary artery atherosclerosis is characterized by coronary artery stenosis less than 50% [1,2,3]. Li et al BMC Cardiovascular Disorders (2020) 20:40 injected into the coronary artery or the brachial artery [10,11,12] This method is poorly accepted due to its invasiveness and high cost. On the contrary, flowmediated dilatation (FMD) [13,14,15] and vascular reactive hyperemia index are noninvasive methods for evaluating endothelial function. They both use the principle of endothelium-dependent vessel diastolic function [16]. Endothelial dysfunction may play a key role in non-obstructive coronary artery atherosclerosis. Our study aimed to evaluate the vascular endothelial function and its influencing factors in patients with nonobstructive coronary artery atherosclerosis
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