Significance of the lipid profile and endothelium-dependent vasodilatation in the pathogenesis of microvascular angina.
BACKGROUND
To investigate the significance of lipid disorders and endothelial dysfunction in the pathogenesis of microvascular angina.


METHODS
Levels of plasma lipids, lipoproteins and apolipoproteins were assessed in 21 patients with microvascular angina and 24 healthy subjects as controls. Also, the endothelium-dependent vasodilatation function was determined with high-resolution ultrasound in both groups.


RESULTS
Levels of serum total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), apolipoprotein B(100) (ApoB(100)) and lipoprotein(a) [Lp(a)] in microvascular angina group were significantly higher than those in healthy subjects (each p < 0.05). The flow-mediated dilatation (FMD) in brachial arteries in patients with microvascular angina declined significantly as compared with that in control subjects (4.7 +/- 1.9% vs. 12.8 +/- 3.7%, p < 0.001). However, no significant difference was observed in response to nitroglycerin between groups (19.7 +/- 8.1% vs. 21.2 +/- 6.6%; p > 0.05). Linear correlation analysis revealed a significant negative correlation between the FMD of brachial arteries and the serum levels of LDL-C and Lp(a) in the microvascular angina group (r = -0.5125 and -0.4271, respectively, both p < 0.001). Subsequently, all subjects were pooled and divided into two groups (groups A and B) according to the degree of FMD in brachial arteries (A pound 4% and B > 4%). The serum LDL-C level was found to be significantly higher in group A than in group B (4.09 +/- 0.65 mmol/L vs. 2.59 +/- 0.49 mmol/L; p < 0.05).


CONCLUSIONS
Plasma lipid disorders and vascular endothelial dysfunction may play important roles in the development of microvascular angina. The dysfunction of endothelium-dependent vasodilation was mainly associated with anomalies in LDL-C and Lp(a), and myocardial endothelial dysfunction was aggravated by lipid abnormalities in patients with microvascular angina.
Liu
Qi-ming
QM
Department of Cardiology, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China. qimingliu@yahoo.com.cn
Zhou
Sheng-hua
SH
Qi
Shu-shan
SS
Zhao
Shui-ping
SP
Minghuib
Liu
L
D000328:Adult; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008055:Lipids / Q000097:blood*; D008297:Male; D017566:Microvascular Angina / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional; D014655:Vascular Resistance; D014664:Vasodilation / Q000502:physiology*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids