title: Is activation in inflammatory bowel diseases associated with further impairment of coronary microcirculation?
abstract: BACKGROUND
  Inflammatory bowel disease [IBD] includes a number of chronic relapsing diseases. In IBD intestinal microvascular endothelial cells are damaged by an abnormal immune response. Several studies have shown that IBD may cause increment in risk of developing atherosclerosis. IBD in activation was related to enhanced risks of worse cardiovascular [CV] outcome, on the other hand no risk increment was seen in remission comparing to control group in those studies. Coronary Flow Reserve [CFR] reflects coronary microvascular circulation. Coronary microvascular dysfunction may be defined as a predictor of CV outcome combined with previous described atherosclerotic risk factors. The present study was purposed to further evaluate whether or not CFR in the left anterior descending artery [LAD] is disturbed in IBD patients with activation in comparison to remission and healthy subjects.
  
  
  METHODS
  62 patients with IBD and 39 healthy volunteers were enrolled into the study. Patients' demographics were recorded. CFR evaluation of patients with IBD in both activation and remission period and control group were performed with transthoracic echocardiography.
  
  
  RESULTS
  CFR was significantly lowest in the active period of the IBD [2.26 [2.08-2.55] vs. 2.55 [2.18-3.00] and 3.10 [2.85-3.29] p<0.001]. CFR is negatively correlated with disease activity scores of IBD.
  
  
  CONCLUSIONS
  This study showed that CFR is more prominently disturbed in patients with IBD in activation. The activation of disease may have a major role in the progression of coronary microcirculatory dysfunction and future cardiovascular events.
authors.affiliation: Baskent University Department of Gastroenterology, Konya, Turkey.
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Caliskan
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey. Electronic address: drnursenkeles@yahoo.com.tr.
authors.forename: Nursen
authors.initials: N
authors.lastname: Keles
authors.affiliation: Baskent University Department of Gastroenterology, Konya, Turkey.
authors.forename: Huseyin Savas
authors.initials: HS
authors.lastname: Gokturk
authors.affiliation: Umraniye Training and Research Hospital Department of Gastroenterology, Istanbul,Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Ozdil
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Feyza
authors.initials: F
authors.lastname: Aksu
authors.affiliation: Umraniye Training and Research Hospital Department of Gastroenterology, Istanbul,Turkey.
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Ozturk
authors.affiliation: Umraniye Training and Research Hospital Department of Gastroenterology, Istanbul,Turkey.
authors.forename: Resul
authors.initials: R
authors.lastname: Kahraman
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Kostek
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Ahmet S
authors.initials: AS
authors.lastname: Tekin
authors.affiliation: Baskent University Department of Gastroenterology, Konya, Turkey.
authors.forename: Gulsum Teke
authors.initials: GT
authors.lastname: Ozgur
authors.affiliation: Istanbul Medeniyet University Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Caliskan
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D012307:Risk Factors
keywords: Activation; Coronary flow reserve; Inflammatory bowel diseases