title: Impaired coronary microvascular and left ventricular diastolic function in patients with inflammatory bowel disease.
abstract: OBJECTIVE
  Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients.
  
  
  METHODS
  Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove-Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography.
  
  
  RESULTS
  Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1±3.9 vs. 22. 4±2.9, p<0.05), and hyperemic DPFV (56.1±12.5 vs. 70.6±15.3, p<0.05) and CFR (2.34±0.44 vs. 3.14±0.54, p<0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR.
  
  
  CONCLUSIONS
  CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP.
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Gastroenterology Department, Konya, Turkey. Electronic address: caliskanzuhal@gmail.com.
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Caliskan
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Gastroenterology Department, Konya, Turkey.
authors.forename: Huseyin Savas
authors.initials: HS
authors.lastname: Gokturk
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Cardiology Department, Konya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Caliskan
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Cardiology Department, Konya, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Gullu
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Cardiology Department, Konya, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Ciftci
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Gastroenterology Department, Konya, Turkey.
authors.forename: Gülsüm Teke
authors.initials: GT
authors.lastname: Ozgur
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Cardiology Department, Konya, Turkey.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Guven
authors.affiliation: Baskent University, Konya Teaching and Medical Research Center, Gastroenterology Department, Konya, Turkey.
authors.forename: Haldun
authors.initials: H
authors.lastname: Selcuk
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003424:Crohn Disease / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D016014:Linear Models; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein
keywords: Atherosclerosis; Coronary flow reserve; Echocardiography; Inflammatory bowel disease; Microvascular function