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dc.contributor.authorNel, Karen
dc.contributor.authorNam, Michael CY
dc.contributor.authorAnstey, Chris
dc.contributor.authorBoos, Christopher J
dc.contributor.authorCarlton, Edward
dc.contributor.authorSenior, Roxy
dc.contributor.authorKaski, Juan Carlos
dc.contributor.authorKhattab, Ahmed
dc.contributor.authorShamley, Delva
dc.contributor.authorByrne, Christopher D
dc.contributor.authorStanton, Tony
dc.contributor.authorGreaves, Kim
dc.date.accessioned2019-09-20T01:27:09Z
dc.date.available2019-09-20T01:27:09Z
dc.date.issued2017
dc.identifier.issn0167-5273
dc.identifier.doi10.1016/j.ijcard.2017.06.023
dc.identifier.urihttp://hdl.handle.net/10072/387558
dc.description.abstractBackground: Although calcific aortic valve disease (CAVD) is associated with coronary atherosclerosis, it is not known whether early CAVD is associated with coronary microcirculatory dysfunction (CMD). We sought to investigate the relationship between myocardial blood flow reserve (MBFR) - a measure of CMD, and early CAVD in the absence of obstructive epicardial coronary artery disease. We also determined whether this relationship was independent of coronary artery disease (CAD) and hs-CRP, a marker of systemic inflammation. Methods: 183 patients with chest pain and unobstructed coronary arteries were studied. Aortic valve calcification score (AVCS), coronary total plaque length (TPL), and coronary calcium score were quantified from multislice CT. MBFR was assessed using vasodilator myocardial contrast echocardiography. Hs-CRP was measured from venous blood using a particle-enhanced immunoassay. Results: Mean (± SD) participant age was 59.8 (9.6) years. Mean AVCS was 68 (258) AU, TPL was 15.6 (22.2) mm, and median coronary calcification score was 43.5 AU. Mean MBFR was 2.20 (0.52). Mean hs-CRP was 2.52 (3.86) mg/l. Multivariable linear regression modelling incorporating demographics, coronary plaque characteristics, MBFR, and inflammatory markers, demonstrated that age (β = 0.05, 95% CI: 0.02, 0.08, P = 0.007), hs-CRP (β = 0.09, CI: 0.02, 0.16, P = 0.010) and diabetes (β = 1.03, CI: 0.08, 1.98, P = 0.033), were positively associated with AVCS. MBFR (β = − 0.87, CI: − 1.44, − 0.30, P = 0.003), BMI (β = − 0.11, CI: − 0.21, − 0.01, P = 0.033), and LDL (β = − 0.32, CI: − 0.61, − 0.03, P = 0.029) were negatively associated with AVCS. TPL and coronary calcium score were not independently associated with AVCS when included in the regression model. Conclusion: Coronary microvascular function as determined by measurement of myocardial blood flow reserve is independently associated with early CAVD. This effect is independent of the presence of coronary artery disease and also systemic inflammation.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofpagefrom427
dc.relation.ispartofpageto432
dc.relation.ispartofjournalInternational Journal of Cardiology
dc.relation.ispartofvolume248
dc.subject.fieldofresearchCardiovascular medicine and haematology
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchcode3201
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsCardiac & Cardiovascular Systems
dc.subject.keywordsCardiovascular System & Cardiology
dc.subject.keywordsAortic valve calcification score
dc.titleMyocardial blood flow reserve is impaired in patients with aortic valve calcification and unobstructed epicardial coronary arteries
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationNel, K; Nam, MCY; Anstey, C; Boos, CJ; Carlton, E; Senior, R; Kaski, JC; Khattab, A; Shamley, D; Byrne, CD; Stanton, T; Greaves, K, Myocardial blood flow reserve is impaired in patients with aortic valve calcification and unobstructed epicardial coronary arteries, International Journal of Cardiology, 2017, 248, pp. 427-432
dcterms.dateAccepted2017-06-07
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated2019-09-20T01:22:37Z
dc.description.versionAccepted Manuscript (AM)
gro.rights.copyright© 2017 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorAnstey, Chris


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