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Coronary flow reserve/diastolic function relationship in angina-suffering patients with normal coronary angiography

Anchisi, Chiara; Marti, Giuliano; Bellacosa, Ilaria; Mary, David; Vacca, Giovanni; Marino, Paolo; Grossini, Elena

Journal of Cardiovascular Medicine: May 2017 - Volume 18 - Issue 5 - p 325–331
doi: 10.2459/JCM.0000000000000344
Coronary artery disease

Aims Coronary blood flow and diastolic function are well known to interfere with each other through mechanical and metabolic mechanisms. We aimed to assess the relationship between coronary flow reserve (CFR) and diastolic dysfunction in patients suffering from angina but with normal coronary angiography.

Methods In 16 patients with chest pain and angiographically normal coronary arteries, CFR was measured using transthoracic echo-Doppler by inducing hyperemia through dipyridamole infusion. Diastolic function (E/A, deceleration time, isovolumetric relaxation time [IVRT], propagation velocity [Vp]) and left ventricular mass were evaluated by means of two-dimensional transthoracic echocardiography.

Results The patients were initially divided into two groups on the grounds of CFR only (ACFR: altered CFR, n = 9; NACFR: unaltered CFR, n = 7). Thereafter they were divided into four groups on the grounds of CFR and diastolic function (NN: normal; AA: altered CFR/diastole; AN: altered CFR/normal diastole; NA: normal CFR/altered diastole). Most of the subjects were scheduled in AA (n = 8) or NA (n = 5) groups, which were taken into consideration for further analysis. Patients were not different regarding various risk factors. ACFR and AA patients were older with normal body weight in comparison with NACFR and NA patients (P < 0.05). In the AA group, CFR and diastolic variables were found to be related to each other.

Conclusion Diastolic dysfunction and reduced CFR were correlated in patients with concomitant alterations of those variables only. Because most risk factors were shared with patients with altered diastolic properties only, our findings could represent a direct relationship between altered CFR and diastole.

aCardiology Clinic

bLaboratory of Physiology and Experimental Surgery, Department of Translational Medicine, Università del Piemonte Orientale ‘A. Avogadro,’ AOU ‘Maggiore della Carità’, Novara, Italy

Correspondence to Professor Elena Grossini, Laboratory of Physiology and Experimental Surgery, Department of Translational Medicine, Università del Piemonte Orientale ‘A. Avogadro’, via Solaroli 17, I-28100 Novara, Italy Tel: +390321660526; fax: +3903213733537; e-mail:

Received 1 July, 2015

Revised 23 October, 2015

Accepted 28 October, 2015

© 2017 Italian Federation of Cardiology. All rights reserved.