title: The association between coronary flow reserve and development of coronary calcifications: a follow-up study for 11 years in healthy young men.
abstract: OBJECTIVE
  We studied whether a reduced coronary flow reserve (CFR) in healthy young men independently predicts the presence of coronary artery disease as assessed by coronary artery calcification after 11 years of follow-up.
  
  
  RESULTS
  Coronary microvascular dysfunction in early stages of coronary artery disease can be detected as a reduced CFR by positron emission tomography (PET). Seventy-seven healthy, lean, normotensive, non-smoking and non-diabetic men underwent 15-Oxygen ((15)O) water myocardial perfusion PET at rest and during vasodilator stress at the age of 35 ± 4 years at baseline. The subjects were followed-up for 11 ± 1 years and the coronary artery calcium score (CCS) was measured with computed tomography at the end of the follow-up. At the end of the follow-up, 30 (39%) individuals had CCS >0 (average 65 ± 93), but none had clinical symptoms or evidence of ischaemia in stress echocardiography. At baseline, the average CFR was comparable in individuals with CCS >0 and CCS = 0 (4.2 ± 1.4 vs. 4.0 ± 1.2, P = 0.4). Logistic regression analysis showed no associations between CFR, serum glucose, cholesterol levels, systolic blood pressure or body mass index at baseline and CCS at the end of the follow-up (P always >0.05). The presence of CCS (CCS >0) was associated with higher systolic and diastolic blood pressures at the end of the follow-up (137 ± 18 vs. 128 ± 11 mmHg, P = 0.04 and 86 ± 12 vs. 78 ± 11 mmHg, P = 0.01).
  
  
  CONCLUSIONS
  Coronary reactivity to vasodilator-induced hyperaemia as assessed by perfusion PET was not predictive of the presence of coronary calcification after 11 years of follow-up in asymptomatic men with very low likelihood of coronary artery disease.
authors.affiliation: Turku PET Centre, Kiinamyllynkatu 4-8, Turku 20520, Finland. vauusi@utu.fi
authors.forename: Valtteri
authors.initials: V
authors.lastname: Uusitalo
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.forename: Sami
authors.initials: S
authors.lastname: Kajander
authors.forename: Matti
authors.initials: M
authors.lastname: Luotolahti
authors.forename: Maria
authors.initials: M
authors.lastname: Wendelin-Saarenhovi
authors.forename: Jan
authors.initials: J
authors.lastname: Sundell
authors.forename: Olli
authors.initials: O
authors.lastname: Raitakari
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002114:Calcinosis / Q000175:diagnosis* / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D025401:Echocardiography, Stress; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed
chemical_list: D001786:Blood Glucose; D002784:Cholesterol