title: Obesity is associated with impaired human coronary endothelial function.
abstract: CONCLUSIONS
  
  
  
  BACKGROUND
  Obesity is an independent risk factor for cardiovascular disease. Endothelial dysfunction assessed in the peripheral circulation is associated with obesity, however, little is known if this association also exists in the coronary circulation.
  
  
  METHODS
  Stable patients with coronary artery disease were evaluated. Baseline characteristics were evaluated, including assessment of body mass index [(BMI), kg/m(2)]. Coronary diameter (quantitative coronary angiography) and blood flow (0.014 in. Doppler Flo-wire) were measured at baseline and in response to intracoronary acetylcholine (10(-7) and 10(-6) M) to evaluate endothelial dependent effects with endothelial independent effects evaluated in response to intracoronary nitroglycerin and adenosine. The cohort was divided into tertiles around BMI values, i.e. normal weight (BMI < 25), overweight (BMI 25-29.9) and obese (BMI ≥ 30) groups.
  
  
  RESULTS
  83 patients were evaluated, with 20 patients in the normal weight (BMI 22.6 ± 0.3 kg/m(2)), 40 subjects in the overweight (BMI 27.3 ± 0.2 kg/m(2)) and 23 in the obese (BMI 34.3 ± 0.3 kg/m(2)) groups. A significant difference was seen in the primary endpoint of Ach mediated % change in coronary blood flow between the normal (101 ± 28%) and the obese (37 ± 15%) groups (p = 0.04). No significant difference was observed in epicardial constrictor response to acetylcholine across these three groups of patients.
  
  
  CONCLUSIONS
  In a cohort of subjects with coronary artery disease, patients with a high BMI had associated impaired microvascular coronary endothelial dependent function.
authors.affiliation: Department of Cardiac Sciences and the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada. Electronic address:matthew.worthley@adelaide.edu.au.
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Worthley
authors.affiliation: Department of Cardiac Sciences and the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Curtis
authors.affiliation: Department of Cardiac Sciences and the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Goodhart
authors.affiliation: Department of Cardiac Sciences and the Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada.
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Anderson