title: Impaired coronary vascular reactivity and functional capacity in women: results from the NHLBI Women's Ischemia Syndrome Evaluation (WISE) Study.
abstract: OBJECTIVE
  We investigated the relationship between coronary vascular reactivity and functional capacity as assessed from the Duke Activity Status Index (DASI) in a cohort of women evaluated for suspected ischemia.
  
  
  BACKGROUND
  Reduced functional capacity and impaired vascular reactivity are associated with poor prognosis, but an association between vascular reactivity and functional capacity is unknown.
  
  
  METHODS
  A total of 190 women enrolled in the National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE) study had baseline clinical assessment and coronary artery flow velocity response to adenosine (CFVR(ado)). We compared these results with self-reported DASI metabolic equivalents (METs).
  
  
  RESULTS
  Mean age was 55 +/- 11 years (range 21 to 83 years), and only 18% had coronary stenosis > or =50%. Women with a CFVR(ado) <2.5 (n = 98) had mean DASI of 15.1 +/- 13.6, compared to women (n = 92) with CFVR(ado) > or =2.5, whose mean DASI was 21.0 +/- 15.2 (p = 0.004). This relationship was maintained after adjusting for age and presence of coronary artery disease. CFVR(ado) of > or =2.5 was associated with a DASI of >20 (odds ratio 3.03, 95% confidence interval 1.56 to 5.90, p = 0.001).
  
  
  CONCLUSIONS
  Women with reduced CFVR(ado) were significantly more likely to have reduced functional capacity. Impairment in coronary vascular function and reduced levels of activity may both play a role in the poorer prognosis observed in the WISE study women; however, the relationship between the two is still unclear.
authors.affiliation: Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida 32610-0277, USA. handbem@medicine.ufl.edu
authors.forename: Eileen
authors.initials: E
authors.lastname: Handberg
authors.forename: B Delia
authors.initials: BD
authors.lastname: Johnson
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Arant
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Wessel
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kerensky
authors.forename: Gregory
authors.initials: G
authors.lastname: von Mering
authors.forename: Marian B
authors.initials: MB
authors.lastname: Olson
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reis
authors.forename: Leslee
authors.initials: L
authors.lastname: Shaw
authors.forename: C Noel
authors.initials: CN
authors.lastname: Bairey Merz
authors.forename: Barry L
authors.initials: BL
authors.lastname: Sharaf
authors.forename: George
authors.initials: G
authors.lastname: Sopko
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Pepine
mesh_terms: D000241:Adenosine / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000187:drug effects; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology*; D011379:Prognosis; D014463:Ultrasonography; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine