Temporal Trends in Angina, Myocardial Perfusion, and Left Ventricular Remodeling in Women With No Obstructive Coronary Artery Disease Over 1‐Year Follow‐Up: Results From WISE‐CVD. Issue 13 (7th July 2020)

• Record Type: Journal Article
• Authors: Quesada, Odayme; Hermel, Melody; Suppogu, Nissi; Aldiwani, Haider; Shufelt, Chrisandra; Mehta, Puja K.; Cook‐Wiens, Galen; Maughan, Jenna; Berman, Daniel S.; Thomson, Louise E. J.; Handberg, Eileen M.; Pepine, Carl J.; Bairey Merz, C. Noel; Wei, Janet
• Is Part Of: Journal of the American Heart Association. Volume 9:Issue 13(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-07-07
• Subjects: angina -- cardiovascular magnetic resonance imaging -- ischemic heart disease -- left ventricular remodeling -- quality of life; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.119.016305
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: Women with ischemia and no obstructive coronary artery disease are increasingly recognized and found to be at risk for major adverse cardiovascular events. Methods and Results: In 214 women with suspected ischemia and no obstructive coronary artery disease who completed baseline and 1‐year follow‐up vasodilatory stress cardiac magnetic resonance imaging, we investigated temporal trends in angina (Seattle Angina Questionnaire [SAQ]), myocardial perfusion reserve index, blood pressure, and left ventricular (LV) remodeling and function from baseline to 1‐year follow‐up and explored associations between these different parameters. We observed concordant positive trends in 4/5 SAQ domains, SAQ‐7, myocardial perfusion reserve index, blood pressure, LV mass, and LV mass‐to‐volume ratio. There was no association between SAQ‐7 improvement and myocardial perfusion reserve index improvement over 1‐year follow‐up ( P =0.1). Higher indexed LV end‐diastolic volume and time to peak filling rate at baseline were associated with increased odds of clinically relevant SAQ‐7 improvement (odds ratio [OR], 1.05; 95% CI, 1.0–1.1; and OR, 2.40; 95% CI, 1.1–5.0, respectively). Hypertension was associated with decreased odds of SAQ‐7 improvement (OR, 0.41; 95% CI, 0.19–0.91). Conclusions: In women with ischemia and no obstructive coronary artery disease clinically treated with cardiac medications over 1 year, we observed concurrent temporal trends toward improvement in SAQ, myocardial perfusion reserve index, blood pressure, LV mass, and LV mass‐to volume ratio. We showed that abnormalities in LV morphology and diastolic function at baseline were predictive of clinically significant improvement in angina at follow‐up, whereas history of hypertension was associated with lower odds. Future studies are needed to assess the mechanisms and treatments responsible for the improvements we observed. Registration: URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT02582021.