title: A reduction of coronary flow reserve is associated with chronic kidney disease and long-term cardio-cerebrovascular events in patients with non-obstructive coronary artery disease and vasospasm.
abstract: BACKGROUND
  Coronary flow reserve (CFR) provides essential information about the coronary microvasculature. Chronic kidney disease (CKD) is a risk factor for cardio-cerebrovascular diseases. We hypothesized that low CFR is associated with CKD and long-term cardio-cerebrovascular events in the patients without obstructive coronary artery diseases and vasospasm.
  
  
  RESULTS
  In this study, 73 patients suspected with coronary artery disease but had no epicardial coronary stenosis and vasospasm were enrolled. There were 13 CKD patients and CFR was measured using the Doppler flow wire methods in the left anterior descending artery. CFR was significantly lower in CKD group than non-CKD group (3.13 ± 0.6 vs. 4.00 ± 1.1, P = 0.007). From multivariate logistic regression analysis, the independent factor associated with the presence of CKD was only CFR (odds ratio 3.85, 95% confidence interval 1.27-11.70, P = 0.017). In the patients with low CFR (≤ 2.8), cardio-cerebrovascular events were more common than those with normal CFR (CFR > 2.8). Besides, in the patients who had both low CFR and CKD, long-term cardio-cerebrovascular events were more likely to occur than those with normal CFR or non-CKD.
  
  
  CONCLUSIONS
  Our data suggest that low CFR is associated with CKD and cardio-cerebrovascular events in the patients without coronary stenosis and vasospasm.
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan. sakanobu@fmu.ac.jp
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Shoji
authors.initials: S
authors.lastname: Iwaya
authors.forename: Takashi
authors.initials: T
authors.lastname: Owada
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Hoshino
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mizukami
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunii
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakazato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Saitoh
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000209:etiology / Q000503:physiopathology*; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000503:physiopathology; D003329:Coronary Vasospasm / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology*; D012307:Risk Factors