Impaired coronary microvascular and left ventricular diastolic function in patients with inflammatory bowel disease

• Published in: Microvascular research Vol. 97; pp. 25 - 30
• Main Authors: Caliskan, Zuhal, Gokturk, Huseyin Savas, Caliskan, Mustafa, Gullu, Hakan, Ciftci, Ozgur, Ozgur, Gülsüm Teke, Guven, Aytekin, Selcuk, Haldun
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2015
• Subjects: Adult; Atherosclerosis; Biomarkers - blood; Blood Flow Velocity; Blood Sedimentation; C-Reactive Protein - analysis; Case-Control Studies; Chi-Square Distribution; Colitis, Ulcerative - blood; Colitis, Ulcerative - complications; Colitis, Ulcerative - diagnosis; Coronary Artery Disease - diagnosis; Coronary Artery Disease - etiology; Coronary Artery Disease - physiopathology; Coronary flow reserve; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Crohn Disease - blood; Crohn Disease - complications; Crohn Disease - diagnosis; Diastole; Echocardiography; Echocardiography, Doppler, Pulsed; Female; Fractional Flow Reserve, Myocardial; Humans; Inflammation Mediators - blood; Inflammatory bowel disease; Linear Models; Male; Microcirculation; Microvascular function; Microvessels - diagnostic imaging; Microvessels - physiopathology; Middle Aged; Predictive Value of Tests; Risk Factors; Severity of Illness Index; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left; Inflammatory bowel disease; Coronary flow reserve; Microvascular function; IBD; Echocardiography; Atherosclerosis
• ISSN: 0026-2862; 1095-9319; 1095-9319
• DOI: 10.1016/j.mvr.2014.08.003

Increased incidence of coronary vascular events in patients with inflammatory bowel disease (IBD) is known. However, the association between coronary microvascular function and IBD has not been fully defined. We aimed to investigate whether coronary flow reserve (CFR) and left ventricular diastolic function were impaired in IBD patients. Seventy-two patients with IBD (36 patients with ulcerative colitis [UC] and 36 Crohn's disease [CD]) were registered. Each subject was evaluated after a minimum 15-day attack-free period. For the control group, 36 age- and sex-matched healthy volunteers were included into the study. IBD clinical disease activity in UC was assessed by the Truelove–Witts Index (TWAS) and in CD by the Crohn's Disease Activity Index (CDAI). In each subject, CFR was measured through transthoracic Doppler echocardiography. Compared to the controls, the CD group and UC group had significantly higher high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate. Baseline diastolic peak flow velocity (DPFV) of the left anterior descending artery (LAD) was significantly higher in the IBD group (24.1±3.9 vs. 22. 4±2.9, p<0.05), and hyperemic DPFV (56.1±12.5 vs. 70.6±15.3, p<0.05) and CFR (2.34±0.44 vs. 3.14±0.54, p<0.05) were significantly lower in the IBD group than in the control group. In stepwise linear regression analysis, hs-CRP and lateral Em/Am ratio were independently correlated with CFR. CFR, reflecting coronary microvascular function, is impaired in patients with IBD. CFR and left ventricular diastolic function parameters are well correlated with hs-CRP.