Effects of aging on coronary flow reserve in patients with no evidence of myocardial perfusion abnormality
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ORIGINAL ARTICLE
Effects of aging on coronary flow reserve in patients with no evidence of myocardial perfusion abnormality Erasta Ramandika1 · Satoshi Kurisu1 · Kazuhiro Nitta1 · Takayuki Hidaka1 · Hiroto Utsunomiya1 · Ken Ishibashi1 · Hiroki Ikenaga1 · Yukihiro Fukuda1 · Yasuki Kihara1 · Yukiko Nakano1 Received: 7 January 2020 / Accepted: 5 June 2020 © Springer Japan KK, part of Springer Nature 2020
Abstract Coronary flow reserve (CFR) reflects the functional capacity of microcirculation to adapt to blood demand during increased cardiac work. We tested the hypothesis that aging had impacts on coronary flow velocities and CFR in patients with no evidence of myocardial perfusion abnormality on single photon emission computed tomography (SPECT). Seventy-six patients undergoing transthoracic Doppler echocardiography with no evidence of myocardial perfusion abnormality on SPECT were enrolled in this study. CFR was defined as the ratio of hyperemic to resting peak diastolic coronary flow velocity. Patients were divided into the three groups based on age: 17 patients aged less than 70 years (Group I), 38 patients aged 70–79 years (Group II), and 21 patients aged 80 years or more (Group III). Compared with Group I, CFR was significantly lower in Group II (p < 0.01) and Group III (p < 0.01). Multivariate linear regression analysis showed that female (β = − 0.26, p = 0.03), cigarette smoking (β = − 0.32, p = 0.004), hemoglobin level (β = − 0.40, p = 0.001) and LV mass index (β = 0.24, p = 0.03) were determinants for resting coronary flow velocity. On the other hand, age (β = -0.30, p = 0.008), hemoglobin level (β = -0.47, p < 0.001) and LV mass index (β = 0.24, p = 0.04) were determinants for hyperemic coronary flow velocity. Age was only determinant for CFR (β = -0.48, p < 0.001). Our data suggested that that aging had a decreased effect on hyperemic coronary flow velocity rather than resting coronary flow velocity, and was further associated with impaired CFR in patients with no evidence of myocardial perfusion abnormality. Keywords Aging · Microcirculation · Coronary flow velocity: echocardiography
Introduction Coronary flow reserve (CFR) represents the ratio of maximal to resting coronary blood flow [1–3]. Given that coronary blood flow is determined predominantly by resistance vessels in the absence of flow-limiting epicardial coronary artery disease, CFR reflects the functional capacity of microcirculation to adapt to blood demand during increased cardiac work. Previous studies have suggested that hypertension [4, 5] or diabetes mellitus [6] impairs CFR, whereas the effects of aging on CFR remain to be investigated [7, 8]. Owing to recent advances in imaging technology, CFR can be accurately measured by transthoracic Doppler * Satoshi Kurisu [email protected] 1
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1‑2‑3 Kasumi‑cho, Minami‑ku, Hiroshima, Japan
echocardiography [3]. CFR, based on echocardiography, has an excellent concordance with invasi
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