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Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction

BACKGROUND: A link between angina with no obstructive coronary artery disease (CAD) and heart failure with preserved left ventricular ejection fraction has been proposed, but evidence in support of this is lacking. In a cross-sectional study, we investigated whether left ventricular diastolic functi...

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Autores principales: Michelsen, Marie Mide, Pena, Adam, Mygind, Naja D., Høst, Nis, Gustafsson, Ida, Hansen, Peter Riis, Hansen, Henrik Steen, Kastrup, Jens, Prescott, Eva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532855/
https://www.ncbi.nlm.nih.gov/pubmed/31120897
http://dx.doi.org/10.1371/journal.pone.0216240
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author Michelsen, Marie Mide
Pena, Adam
Mygind, Naja D.
Høst, Nis
Gustafsson, Ida
Hansen, Peter Riis
Hansen, Henrik Steen
Kastrup, Jens
Prescott, Eva
author_facet Michelsen, Marie Mide
Pena, Adam
Mygind, Naja D.
Høst, Nis
Gustafsson, Ida
Hansen, Peter Riis
Hansen, Henrik Steen
Kastrup, Jens
Prescott, Eva
author_sort Michelsen, Marie Mide
collection PubMed
description BACKGROUND: A link between angina with no obstructive coronary artery disease (CAD) and heart failure with preserved left ventricular ejection fraction has been proposed, but evidence in support of this is lacking. In a cross-sectional study, we investigated whether left ventricular diastolic function in women with angina pectoris and no obstructive CAD differed from a reference population. METHODS: We included 956 women with angina and <50% coronary artery stenosis at invasive coronary angiography. Women with cardiovascular risk factors, but no history of chest pain or cardiac disease served as controls (n = 214). Left ventricular diastolic function was assessed by transthoracic echocardiography. RESULTS: The women with angina were slightly older, had higher body mass index, higher heart rate, and more had diabetes compared with controls while systolic blood pressure was lower. In age-adjusted analyses, angina patients had significantly lower E/A (Estimated difference -0.13, 95% CI: -0.17; -0.08), higher left ventricular mass index (5.73 g/m(2), 95% CI: 3.71; 7.75), left atrial volume index (2.34 ml/m(2), 95% CI: 1.23; 3.45) and E/e’ (0.68, 95% CI: 0.30; 1.05) and a larger proportion had higher estimated left ventricular filling pressure (17% versus 6%, p = 0.001). No between group differences were seen for e’ or deceleration time. After adjustment for known cardiovascular risk factors, between group differences for echocardiographic parameters remained statistically significant. CONCLUSIONS: Patients with angina and no obstructive CAD had a more impaired left ventricular diastolic function compared with an asymptomatic reference population. This suggests some common pathophysiological pathway between the two syndromes.
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spelling pubmed-65328552019-06-05 Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction Michelsen, Marie Mide Pena, Adam Mygind, Naja D. Høst, Nis Gustafsson, Ida Hansen, Peter Riis Hansen, Henrik Steen Kastrup, Jens Prescott, Eva PLoS One Research Article BACKGROUND: A link between angina with no obstructive coronary artery disease (CAD) and heart failure with preserved left ventricular ejection fraction has been proposed, but evidence in support of this is lacking. In a cross-sectional study, we investigated whether left ventricular diastolic function in women with angina pectoris and no obstructive CAD differed from a reference population. METHODS: We included 956 women with angina and <50% coronary artery stenosis at invasive coronary angiography. Women with cardiovascular risk factors, but no history of chest pain or cardiac disease served as controls (n = 214). Left ventricular diastolic function was assessed by transthoracic echocardiography. RESULTS: The women with angina were slightly older, had higher body mass index, higher heart rate, and more had diabetes compared with controls while systolic blood pressure was lower. In age-adjusted analyses, angina patients had significantly lower E/A (Estimated difference -0.13, 95% CI: -0.17; -0.08), higher left ventricular mass index (5.73 g/m(2), 95% CI: 3.71; 7.75), left atrial volume index (2.34 ml/m(2), 95% CI: 1.23; 3.45) and E/e’ (0.68, 95% CI: 0.30; 1.05) and a larger proportion had higher estimated left ventricular filling pressure (17% versus 6%, p = 0.001). No between group differences were seen for e’ or deceleration time. After adjustment for known cardiovascular risk factors, between group differences for echocardiographic parameters remained statistically significant. CONCLUSIONS: Patients with angina and no obstructive CAD had a more impaired left ventricular diastolic function compared with an asymptomatic reference population. This suggests some common pathophysiological pathway between the two syndromes. Public Library of Science 2019-05-23 /pmc/articles/PMC6532855/ /pubmed/31120897 http://dx.doi.org/10.1371/journal.pone.0216240 Text en © 2019 Michelsen et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Michelsen, Marie Mide
Pena, Adam
Mygind, Naja D.
Høst, Nis
Gustafsson, Ida
Hansen, Peter Riis
Hansen, Henrik Steen
Kastrup, Jens
Prescott, Eva
Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction
title Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction
title_full Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction
title_fullStr Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction
title_full_unstemmed Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction
title_short Overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction
title_sort overlap between angina without obstructive coronary artery disease and left ventricular diastolic dysfunction with preserved ejection fraction
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532855/
https://www.ncbi.nlm.nih.gov/pubmed/31120897
http://dx.doi.org/10.1371/journal.pone.0216240
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