CLINICAL RESEARCH: CORONARY RISK FACTORS AND ENDOTHELIAL DYSFUNCTION
Coronary Risk Factors and Myocardial Perfusion in Asymptomatic Adults
The Multi-Ethnic Study of Atherosclerosis (MESA)
Lu Wang, MD, PhD*,
Michael Jerosch-Herold, PhD , ,*,
David R. Jacobs, Jr, PhD*, ,
Eyal Shahar, MD, MPH* and
Aaron R. Folsom, MD, MPH*
* Division of Epidemiology, School of Public Health, School of Medicine, University of Minnesota, Minneapolis, Minnesota
Department of Radiology, School of Medicine, University of Minnesota, Minneapolis, Minnesota
Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon
Department of Nutrition, University of Oslo, Oslo, Norway
Manuscript received May 20, 2005;
revised manuscript received September 5, 2005,
accepted September 19, 2005.
* Reprint requests and correspondence: Dr. Michael Jerosch-Herold, Advanced Imaging Research Center, MS L452, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239 (Email: jeroschh{at}ohsu.edu).
OBJECTIVES: The purpose of this study was to determine the cross-sectional relation between myocardial perfusion and coronary heart disease (CHD) risk factors among adults with no clinical CHD.
BACKGROUND: Clinical studies suggest that myocardial perfusion is often abnormal in individuals without CHD but with risk factors. Epidemiologic study in asymptomatic populations is lacking.
METHODS: Two hundred twenty-two men and women, ages 45 to 84 years and free of a CHD diagnosis, in the University of Minnesota field center of the Multi-Ethnic Study of Atherosclerosis (MESA) had myocardial blood flow (MBF) determined using cardiac magnetic resonance imaging at rest and during adenosine-induced hyperemia. Perfusion reserve (PR) was calculated as the ratio of hyperemic to rest MBF.
RESULTS: Both resting and hyperemic MBF were lower in men than in women, even after considering age and menopause. Hyperemic MBF was also significantly lower in subjects who were older, and in those with higher blood pressure, higher fasting glucose, and lower low-density lipoprotein cholesterol. After adjusting for age, gender, and race, reduced PR was independently associated with hypertension, higher diastolic blood pressure, and higher total and low-density lipoprotein cholesterol, but was not associated with cigarette smoking, obesity, physical activity, or diabetes. Moreover, hyperemic MBF and PR were correlated strongly and inversely with estimated 10-year CHD risk based on Framingham equations (p for trends: <0.0001).
CONCLUSIONS: Coronary vasoreactivity is reduced in asymptomatic individuals with a greater coronary risk factor burden. Our study results imply that changes in coronary vascular reactivity, in response to risk factors, may be detected in adults without symptomatic CHD.
|
Abbreviations and Acronyms
| | ANOVA = analysis of variance | | AV = atrial-ventricular | | BMI = body mass index | | CHD = coronary heart disease | | CMR = cardiac magnetic resonance imaging | | HDL = high-density lipoprotein | | IV = intravenous | | LDL = low-density lipoprotein | | MBF = myocardial blood flow | | MESA = Multi-Ethnic Study of Atherosclerosis | | PR = perfusion reserve | | RPP = rate-pressure product | | SI = signal intensity |
|
This article has been cited by other articles:
|
|
|
|
 
R. Gebker, C. Jahnke, R. Manka, A. Hamdan, B. Schnackenburg, E. Fleck, and I. Paetsch
Additional Value of Myocardial Perfusion Imaging During Dobutamine Stress Magnetic Resonance for the Assessment of Coronary Artery Disease
Circ Cardiovasc Imaging,
September 1, 2008;
1(2):
122 - 130.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. I. Levy, E. L. Schiffrin, J.-J. Mourad, D. Agostini, E. Vicaut, M. E. Safar, and H. A.J. Struijker-Boudier
Impaired Tissue Perfusion: A Pathology Common to Hypertension, Obesity, and Diabetes Mellitus
Circulation,
August 26, 2008;
118(9):
968 - 976.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Stangl, V. Witzel, G. Baumann, and K. Stangl
Current diagnostic concepts to detect coronary artery disease in women
Eur. Heart J.,
March 2, 2008;
29(6):
707 - 717.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S.H. Cheng, J. B. Selvanayagam, M. Jerosch-Herold, W. J. van Gaal, T. D. Karamitsos, S. Neubauer, and A. P. Banning
Percutaneous Treatment of Chronic Total Coronary Occlusions Improves Regional Hyperemic Myocardial Blood Flow and Contractility: Insights From Quantitative Cardiovascular Magnetic Resonance Imaging
J. Am. Coll. Cardiol. Intv.,
February 1, 2008;
1(1):
44 - 53.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Wang, T. Y. Wong, A. R. Sharrett, R. Klein, A. R. Folsom, and M. Jerosch-Herold
Relationship Between Retinal Arteriolar Narrowing and Myocardial Perfusion: Multi-Ethnic Study of Atherosclerosis
Hypertension,
January 1, 2008;
51(1):
119 - 126.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Ebeling Barbier, T. Bjerner, T. Hansen, J. Andersson, L. Lind, J. Hulthe, L. Johansson, and H. Ahlstrom
Clinically Unrecognized Myocardial Infarction Detected at MR Imaging May Not Be Associated with Atherosclerosis
Radiology,
October 1, 2007;
245(1):
103 - 110.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Costa, S. Shoemaker, H. Futamatsu, C. Klassen, D. J. Angiolillo, M. Nguyen, A. Siuciak, P. Gilmore, M. M. Zenni, L. Guzman, et al.
Quantitative Magnetic Resonance Perfusion Imaging Detects Anatomic and Physiologic Coronary Artery Disease as Measured by Coronary Angiography and Fractional Flow Reserve
J. Am. Coll. Cardiol.,
August 7, 2007;
50(6):
514 - 522.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. V. Joffe, R. Y. Kwong, M. D. Gerhard-Herman, C. Rice, K. Feldman, and G. K. Adler
Beneficial Effects of Eplerenone Versus Hydrochlorothiazide on Coronary Circulatory Function in Patients with Diabetes Mellitus
J. Clin. Endocrinol. Metab.,
July 1, 2007;
92(7):
2552 - 2558.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S.H. Cheng, T. J. Pegg, T. D. Karamitsos, N. Searle, M. Jerosch-Herold, R. P. Choudhury, A. P. Banning, S. Neubauer, M. D. Robson, and J. B. Selvanayagam
Cardiovascular Magnetic Resonance Perfusion Imaging at 3-Tesla for the Detection of Coronary Artery Disease: A Comparison With 1.5-Tesla
J. Am. Coll. Cardiol.,
June 26, 2007;
49(25):
2440 - 2449.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. E. Petersen, M. Jerosch-Herold, L. E. Hudsmith, M. D. Robson, J. M. Francis, H. A. Doll, J. B. Selvanayagam, S. Neubauer, and H. Watkins
Evidence for Microvascular Dysfunction in Hypertrophic Cardiomyopathy: New Insights From Multiparametric Magnetic Resonance Imaging
Circulation,
May 8, 2007;
115(18):
2418 - 2425.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. Rosen, J. A.C. Lima, K. Nasir, T. Edvardsen, A. R. Folsom, S. Lai, D. A. Bluemke, and M. Jerosch-Herold
Lower Myocardial Perfusion Reserve Is Associated With Decreased Regional Left Ventricular Function in Asymptomatic Participants of the Multi-Ethnic Study of Atherosclerosis
Circulation,
July 25, 2006;
114(4):
289 - 297.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
