title: Change of coronary flow velocity during the cold pressor test is related to endothelial markers in subjects with chest pain and a normal coronary angiogram.
abstract: BACKGROUND
  Several studies demonstrated that endothelial or atherosclerotic biomarkers, including plasma free insulin-like growth factor-I(IGF-I), soluble CD40 ligand (sCD40L), adiponectin, and leptin have an influence on coronary endothelial function.
  
  
  OBJECTIVE
  The aim of the present study was to investigate whether change of coronary flow velocity of the distal left anterior descending artery (LAD) during the cold pressor test (CPT) with transthoracic Doppler echocardiography (TTE) was associated with these biomarkers in subjects with chest pain and a normal coronary angiogram.
  
  
  METHODS
  In 190 subjects (mean age, 54±11 years; male:female, 113:77) with chest pain and a normal coronary angiogram, peak diastolic velocity (PDV) of the distal LAD during the CPT with TTE was assessed. Acetylcholine provocation test was performed in 58 subjects (mean age, 51±10 years) who were clinically suspected of vasospasm. CPT%PDV was defined as the percent change in PDV during the CPT. Associations between CPT%PDV and clinical parameters were analyzed.
  
  
  RESULTS
  According to multiple regression analysis, CPT%PDV was associated with plasma free IGF-I in the entire study population (β=0.295, P<0.001 in all subjects; β=0.341, P=0.001 in males; β=0.243, P=0.037 in females; β=0.303, P=0.002 in nonsmokers; and β=0.256, P=0.047 in smokers), and sCD40L in males (β=-0.269, P=0.008)and smokers (β=-0.261, P=0.046). Subjects with vasospasm to intracoronary acetylcholine had lower plasma free IGF-I(6.9±3.3 vs 8.9±3.4, P=0.026) and CPT%PDV (8.8±24.9 vs 52.7±26.0, P<0.001) than the others. Plasma adiponectin and leptin were not associated with CPT%PDV.
  
  
  CONCLUSIONS
  Change of coronary flow velocity assessed using the CPT with TTE may be related to endothelial markers, especially plasma free IGF-I.
authors.affiliation: Division of Cardiology, Department of Internal Medicine College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Hui-Jeong
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Youn
authors.forename: Man-Young
authors.initials: MY
authors.lastname: Lee
authors.forename: Chul-Soo
authors.initials: CS
authors.lastname: Park
authors.forename: Yun-Seok
authors.initials: YS
authors.lastname: Choi
authors.forename: Woo-Baek
authors.initials: WB
authors.lastname: Chung
authors.forename: Jae-Beom
authors.initials: JB
authors.lastname: Lee
authors.forename: Byungju
authors.initials: B
authors.lastname: Shim
mesh_terms: D052242:Adiponectin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D023201:CD40 Ligand / Q000097:blood*; D002637:Chest Pain / Q000503:physiopathology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood*; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D004452:Echocardiography; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I; D020738:Leptin / Q000097:blood*; D008297:Male; D012044:Regression Analysis
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D020738:Leptin; D023201:CD40 Ligand; D007334:Insulin-Like Growth Factor I
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