Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational Study
Background We aimed to investigate the presence and severity of coronary microvascular dysfunction (CMD) in inflammatory bowel disease (IBD) including Crohn disease and ulcerative colitis and to elucidate the influence of surgical resection of the diseased intestines on CMD by assessing coronary flo...
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| Format: | Article |
| Language: | English |
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Wiley
2021-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019125 |
| _version_ | 1819179064127127552 |
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| author | Kentaro Kakuta Kaoru Dohi Takayuki Yamamoto Naoki Fujimoto Takahiro Shimoyama Satoru Umegae Masaaki Ito |
| author_facet | Kentaro Kakuta Kaoru Dohi Takayuki Yamamoto Naoki Fujimoto Takahiro Shimoyama Satoru Umegae Masaaki Ito |
| author_sort | Kentaro Kakuta |
| collection | DOAJ |
| description | Background We aimed to investigate the presence and severity of coronary microvascular dysfunction (CMD) in inflammatory bowel disease (IBD) including Crohn disease and ulcerative colitis and to elucidate the influence of surgical resection of the diseased intestines on CMD by assessing coronary flow velocity reserve (CFVR) using transthoracic Doppler echocardiography. Methods and Results Thirty‐seven patients with IBD (aged 44±15 years; 22 patients with Crohn disease and 15 patients with ulcerative colitis) and 30 controls (aged 46±12 years) were enrolled. For CFVR measurement, coronary flow velocity was recorded at rest and during hyperemia by ADP infusion using transthoracic Doppler echocardiography, and CFVR <2.5 defined CMD. CFVR measurement was repeated before and within 1 year after surgery. CFVR was similarly and significantly lower in patients with Crohn disease and those with ulcerative colitis than controls (Crohn disease: 2.92±1.03 [P<0.05 versus controls], ulcerative colitis: 2.99±0.65 [P<0.05 versus controls], and controls: 3.84±0.75). Multiple linear regression analysis showed that the presence of IBD and baseline hs‐CRP (high‐sensitivity C‐reactive protein) were independently associated with low CFVR among all study participants (β=−0.403 [P=0.001] and −0.237 [P=0.037], respectively). Hyperemic coronary flow velocity significantly improved after surgery only in patients with IBD who had CMD. CFVR significantly improved in patients with IBD who had both CMD and non‐CMD, and the extent of CFVR improvements were greater in patients with CMD than non‐CMD. Multiple linear regression analysis showed that the reduction of hs‐CRP was independently associated with improvement of hyperemic coronary flow velocity and CFVR among all patients with IBD (β=−0.481 [P=0.003] and β=−0.334 [P=0.043], respectively). Conclusions IBD is associated with CMD, which improved after surgical resection of diseased intestines. |
| first_indexed | 2024-12-22T21:52:30Z |
| format | Article |
| id | doaj.art-a8659069fd894aa78736b6a4312e1683 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T21:52:30Z |
| publishDate | 2021-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-a8659069fd894aa78736b6a4312e16832022-12-21T18:11:20ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-05-0110910.1161/JAHA.120.019125Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational StudyKentaro Kakuta0Kaoru Dohi1Takayuki Yamamoto2Naoki Fujimoto3Takahiro Shimoyama4Satoru Umegae5Masaaki Ito6Department of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu JapanDepartment of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu JapanInflammatory Bowel Disease Center Japan Community Health care Organization Yokkaichi Hazu Medical Center Yokkaichi JapanDepartment of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu JapanInflammatory Bowel Disease Center Japan Community Health care Organization Yokkaichi Hazu Medical Center Yokkaichi JapanInflammatory Bowel Disease Center Japan Community Health care Organization Yokkaichi Hazu Medical Center Yokkaichi JapanDepartment of Cardiology and Nephrology Mie University Graduate School of Medicine Tsu JapanBackground We aimed to investigate the presence and severity of coronary microvascular dysfunction (CMD) in inflammatory bowel disease (IBD) including Crohn disease and ulcerative colitis and to elucidate the influence of surgical resection of the diseased intestines on CMD by assessing coronary flow velocity reserve (CFVR) using transthoracic Doppler echocardiography. Methods and Results Thirty‐seven patients with IBD (aged 44±15 years; 22 patients with Crohn disease and 15 patients with ulcerative colitis) and 30 controls (aged 46±12 years) were enrolled. For CFVR measurement, coronary flow velocity was recorded at rest and during hyperemia by ADP infusion using transthoracic Doppler echocardiography, and CFVR <2.5 defined CMD. CFVR measurement was repeated before and within 1 year after surgery. CFVR was similarly and significantly lower in patients with Crohn disease and those with ulcerative colitis than controls (Crohn disease: 2.92±1.03 [P<0.05 versus controls], ulcerative colitis: 2.99±0.65 [P<0.05 versus controls], and controls: 3.84±0.75). Multiple linear regression analysis showed that the presence of IBD and baseline hs‐CRP (high‐sensitivity C‐reactive protein) were independently associated with low CFVR among all study participants (β=−0.403 [P=0.001] and −0.237 [P=0.037], respectively). Hyperemic coronary flow velocity significantly improved after surgery only in patients with IBD who had CMD. CFVR significantly improved in patients with IBD who had both CMD and non‐CMD, and the extent of CFVR improvements were greater in patients with CMD than non‐CMD. Multiple linear regression analysis showed that the reduction of hs‐CRP was independently associated with improvement of hyperemic coronary flow velocity and CFVR among all patients with IBD (β=−0.481 [P=0.003] and β=−0.334 [P=0.043], respectively). Conclusions IBD is associated with CMD, which improved after surgical resection of diseased intestines.https://www.ahajournals.org/doi/10.1161/JAHA.120.019125coronary microvascular dysfunctionechocardiographyinflammation |
| spellingShingle | Kentaro Kakuta Kaoru Dohi Takayuki Yamamoto Naoki Fujimoto Takahiro Shimoyama Satoru Umegae Masaaki Ito Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary microvascular dysfunction echocardiography inflammation |
| title | Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational Study |
| title_full | Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational Study |
| title_fullStr | Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational Study |
| title_full_unstemmed | Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational Study |
| title_short | Coronary Microvascular Dysfunction Restored After Surgery in Inflammatory Bowel Disease: A Prospective Observational Study |
| title_sort | coronary microvascular dysfunction restored after surgery in inflammatory bowel disease a prospective observational study |
| topic | coronary microvascular dysfunction echocardiography inflammation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019125 |
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