Abstract
BackgroundLong-term intake of long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs), especially eicosapentaenoic acid (EPA) is associated with a low risk for cardiovascular disease. Phase-contrast cine cardiovascular magnetic resonance (PC cine CMR) can assess coronary flow reserve (CFR). The present study investigates the relationship between CFR evaluated by PC cine CMR and the serum EPA.MethodsWe studied 127 patients (male, 116 (91%); mean age, 72.2 ± 7.4 years) with known or suspected coronary artery disease (CAD). X-ray coronary angiography revealed no significant coronary arterial stenoses (defined as luminal diameter reduction ≥50% on quantitative coronary angiogram (QCA) analysis) in all study participants. Breath-hold PC cine CMR images of the coronary sinus (CS) were acquired to assess blood flow of the CS both at rest and during adenosine triphosphate (ATP) infusion. We calculated CFR as CS blood flow during ATP infusion divided by that at rest. Patients were allocated to groups according to whether they had high (n = 64, EPA ≥ 75.8 μg/mL) or low (n = 63, EPA < 75.8 μg/mL) median serum EPA.ResultsCFR was significantly lower in the low, than in the high EPA group (2.54 ± 1.00 vs. 2.91 ± 0.98, p = 0.038). Serum EPA positively correlated with CFR (R = 0.35, p < 0.001). We defined preserved CFR as > 2.5, which is the previously reported lower limit of normal flow reserve without obstructive CAD. Multivariate analysis revealed that EPA is an independent predictor of CFR > 2.5 (odds ratio, 1.01; 95% confidence interval, 1.00 – 1.02, p = 0.008).ConclusionsThe serum EPA is significantly correlated with CFR in CAD patients without significant coronary artery stenosis.
Highlights
Long-term intake of long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs), especially eicosapentaenoic acid (EPA) is associated with a low risk for cardiovascular disease
No significant difference between low and high EPA groups was found in HR, SBP, DBP and rate pressure products (RPP) at rest and during adenosine triphosphate (ATP) infusion
Corrected coronary sinus blood flow was significantly augmented by ATP infusion in the low and high EPA groups, whereas ΔCS flow was significantly lower in the group with low EPA (112.4 ± 73.7 vs. 147.2 ± 77.7 mL/min, p = 0.036)
Summary
Long-term intake of long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs), especially eicosapentaenoic acid (EPA) is associated with a low risk for cardiovascular disease. Phase-contrast cine cardiovascular magnetic resonance (PC cine CMR) can assess coronary flow reserve (CFR). Phase-contrast cine cardiovascular magnetic resonance (PC cine CMR) is a promising approach to quantifying global myocardial blood flow in the left ventricular (LV) myocardium without exposure to radiation [15,16,17,18,19]. The accuracy of this technique has been validated in phantoms [20], in animals using flow probes [18] and in humans using positron emission tomography (PET) [16]. As the presence of significant coronary artery stenosis affects the CFR, we enrolled the CAD patients without ≥50% diameter stenosis on X-ray coronary angiography (CAG)
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