Chronic inflammation and impaired coronary vasoreactivity in patients with coronary risk factors.
BACKGROUND
The goal of this study was to examine a possible association between systemic microinflammation, as reflected by C-reactive protein (CRP) serum levels, and coronary vasomotion in patients with coronary risk factors but with angiographically normal coronary arteries.


RESULTS
Coronary vasomotor function was studied in response to cold pressor testing (CPT) in 71 patients with normal angiograms. In all patients, CPT-induced changes in epicardial luminal area (LA; mm2) were assessed with quantitative angiography. Within 20 days, myocardial blood flow (MBF) responses to CPT were measured (mL x g(-1) x min(-1)) noninvasively with 13N-ammonia and PET imaging. The CPT-induced mean changes in LA and in MBF in patients with elevated CRP (> or =0.5 mg/dL) were significantly impaired compared with patients presenting with CRP levels within normal range (<0.5 mg/dL) (DeltaLA, -1.09+/-0.86 versus 0.45+/-0.63 mm2; DeltaMBF, 0.06+/-0.18 versus 0.44+/-0.31 mL x g(-1) x min(-1); P<0.0001, respectively). Coronary LA changes and MBF responses to CPT were inversely correlated with CRP serum levels (r=-0.84 and r=-0.63; P<0.0001). Lastly, regression analysis revealed a significant correlation between the changes in LA and MBF during CPT for patients with elevated CRP levels and those for patients with normal CRP levels (r=0.56 and r=0.66; P<0.001).


CONCLUSIONS
These findings suggest a direct association between systemic microinflammation and altered coronary vasomotor function of both the epicardial conductance and the arteriolar resistance vessels.
Schindler
Thomas H
TH
Department of Pharmacology, David Geffen School of Medicine at UCLA, B2-045J CHS, Box 956948, Los Angeles, CA 90095-6948, USA. tschindler@mednet.ucla.edu
Nitzsche
Egbert U
EU
Olschewski
Manfred
M
Magosaki
Nobuhisa
N
Mix
Michael
M
Prior
John O
JO
Facta
Alvaro D
AD
Solzbach
Ulrich
U
Just
Hanjoerg
H
Schelbert
Heinrich R
HR
D000368:Aged; D001160:Arterioles / Q000503:physiopathology; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis*; D003080:Cold Temperature; D015897:Comorbidity; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014655:Vascular Resistance; D014661:Vasoconstriction; D014666:Vasomotor System / Q000503:physiopathology*
D015415:Biomarkers; D002097:C-Reactive Protein