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A1411

JACC April 1, 2014


Volume 63, Issue 12

Prevention
B-type Natriuretic Peptide Does Not Correlate with Invasive or Noninvasive Measures
of Coronary Microvascular Dysfunction in Women with Preserved Ejection Fraction:
A Report from the Womens Ischemia Syndrome Evaluation- Coronary Vascular
Dysfunction (WISE-CVD) Study
Poster Contributions
Hall C
Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m.

Session Title: Prevention: Gender, Race/Ethnicity, and Preventive Interventions


Abstract Category: 20. Prevention: Clinical
Presentation Number: 1219-133
Authors: Erika Jones, Janet Wei, Puja Mehta, Chrisandra Shufelt, Margo Minissian, Carl Pepine, Eileen Handberg, Xiao Zhang, Andre Rogatko,
George Sopko, C. Noel Bairey Merz, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Background: Women with symptoms/signs of ischemia and no obstructive coronary artery disease often have coronary microvascular dysfunction
(CMD), diagnosed by invasive coronary reactivity testing (CRT). CMD has recently been proposed to be a precursor to heart failure with preserved
ejection fraction. The relationship between b-type natriuretic peptide (BNP) and CMD has not been well defined in women with persistent angina but
preserved ejection fraction.
Methods: We evaluated BNP levels in 224 women with suspected CMD who underwent CRT in the left anterior descending artery and stress
cardiac magnetic resonance imaging (CMRI). CRT measured left ventricular end-diastolic pressure at rest, coronary flow reserve to adenosine and
coronary blood flow and diameter change with acetylcholine. CMRI myocardial perfusion reserve index was obtained using CAAS MRV 3.3 software
(Pie Medical Imaging). Pearson correlation using log BNP was performed for statistical analysis.
Results: Mean BNP was 114 159 pg/mL, increased with age and decreased with body mass index. All of the women had normal ejection fraction
(68 11%). There was no relationship between BNP and invasive or noninvasive measurements of CMD (Table).
Conclusion: BNP did not correlate with invasive or noninvasive measurements of CMD in women with persistent angina but no clinical signs of
heart failure. This observational study suggests that BNP is not a useful test for predicting CMD in this population.
Pearson Correlation of Log BNP with Patient Characteristics and Coronary Microvascular Dysfunction
Age
Body Mass Index
Myocardial Perfusion Reserve Index
Coronary Flow Reserve
to Adenosine(normal >2.5)
Coronary Blood Flow Change
to Acetylcholine(normal > 50%)
Coronary Diameter Change
to Acetylcholine(normal >0%)
Left Ventricular End-Diastolic Pressure

Mean Standard Deviation


53 11 years
30 8.6
1.8 0.5

Correlation Coefficient
0.33
-0.23
-0.09

P value
<0.0001
0.0002
0.22

2.5 0.52

-0.08

0.43

1.9 27 %

-0.01

0.86

- 9.5 21 %

0.01

0.89

14.7 4.9 mmHg

0.06

0.39

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