Impaired peripheral microvascular reactivity in patients with nonobstructive coronary artery disease

IF 1.9 4区医学 Q3 HEMATOLOGY Microcirculation Pub Date : 2023-04-20 DOI:10.1111/micc.12807

Zulkefli Sanip, Nurnajwa Pahimi, Nur Adilah Bokti, Zurkurnai Yusof, Mohd Sapawi Mohamed, W. Yus Haniff W. Isa, Aida Hanum Rasool

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Abstract

Objective

This study aimed to determine whether peripheral microvascular reactivity is impaired in patients with nonobstructive coronary artery disease (NOCAD).

Methods

Stable patients presenting with angina were recruited and, based on results from coronary angiography, were categorized into OCAD (coronary stenosis of ≥50%) and NOCAD (stenosis <50%) groups. A control group with no history of angina was also recruited. Forearm skin microvascular reactivity was measured using the laser Doppler blood perfusion monitor and the process of postocclusive skin reactive hyperemia (PORH).

Results

Patients were categorized into OCAD (n = 42), NOCAD (n = 40), and control (n = 39) groups. Compared with the control group, the PORH perfusion percent change (PORH% change) was significantly lower in the OCAD and NOCAD groups. No significant differences were noted between the OCAD and NOCAD groups. Additionally, the NOCAD group without any coronary obstruction takes a longer time to reach peak perfusion and had lower PORH% change compared with the nonangina control group.

Conclusion

Angina patients with NOCAD have microvascular dysfunction as demonstrated by reduced magnitude of reperfusion with an ischemic stimulus. NOCAD patients without coronary obstruction also displayed a slower response to reperfusion.

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非阻塞性冠状动脉疾病患者外周血微血管反应性受损

目的本研究旨在确定非阻塞性冠状动脉疾病（NOCAD）患者外周微血管反应性是否受损。方法招募稳定性心绞痛患者，根据冠状动脉造影结果，将其分为OCAD组（冠状动脉狭窄≥50%）和NOCAD组（狭窄＜50%）。还招募了一个没有心绞痛病史的对照组。应用激光多普勒血流灌注监测仪和咬合后皮肤反应性充血（PORH）过程测量前臂皮肤微血管反应性。结果患者分为OCAD（n = 42），NOCAD（n = 40）和控制（n = 39）组。与对照组相比，OCAD和NOCAD组的PORH灌注百分比变化（PORH%变化）显著降低。OCAD组和NOCAD组之间没有显著差异。此外，与非冠心病对照组相比，无任何冠状动脉阻塞的NOCAD组需要更长的时间才能达到峰值灌注，并且PORH%变化更低。结论NOCAD心绞痛患者存在微血管功能障碍，其表现为缺血刺激后再灌注强度降低。没有冠状动脉阻塞的NOCAD患者对再灌注的反应也较慢。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.