A1 Refereed original research article in a scientific journal
Coronary flow reserve in young men with familial combined hyperlipidemia
Authors: Pitkanen OP, Nuutila P, Raitakari OT, Porkka K, Iida H, Nuotio I, Ronnemaa T, Viikari J, Taskinen MR, Ehnholm C, Knuuti J
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Publication year: 1999
Journal: Circulation
Journal name in source: CIRCULATION
Journal acronym: CIRCULATION
Volume: 99
Issue: 13
First page : 1678
Last page: 1684
Number of pages: 7
ISSN: 0009-7322
DOI: https://doi.org/10.1161/01.CIR.99.13.1678
Abstract
Background-Familial combined hyperlipidemia (FCHL) is a common hereditary disorder of lipoprotein metabolism estimated to cause 10% to 20% of premature coronary heart disease. We investigated whether functional abnormalities exist in coronary reactivity in asymptomatic patients with FCHL.Methods and Results-We studied 21 male FCHL patients (age, 34.8+/-5.4 years) and a matched group of 21 healthy control subjects. Myocardial blood flow (MBF) was measured at baseline and during dipyridamole-induced hyperemia with PET and O-15-labeled water. The baseline MBF was similar in patients and control subjects (0.79+/-0.19 versus 0.88+/-0.20 mL.g(-1).min(-1), P=NS). An increase in MBF was seen in both groups after dipyridamole infusion, but MBF at maximal vasodilation was lower in FCHL patients (3.54+/-1.59 versus 4.54+/-1.17 mL.g(-1).min(-1), P=0.025). The difference in coronary flow reserve (CFR) was not statistically significant (4.7+/-2.2 versus 5.3+/-1.6, P=NS, patients versus control subjects). Considerable variability in CFR values-was detected within the FCHL group. Patients with phenotype IIB (n=8) bad lower now during hyperemia (2.5+/-1.2versus 4.2+/-1.5 mL.g(-1).min(-1), P<0.05) and lower CFR (3.4+/-2.1 versus 5.4+/-2.0, P<0.05) compared with phenotype IIA (n=13).Conclusions-Abnormalities in coronary flow regulation exist in young asymptomatic FCHL patients expressing phenotype IIB (characterized by abnormalities in both serum cholesterol and triglyceride concentrations). This is in line with previous observations suggesting that the metabolic abnormalities related to the pathophysiology of FCHL are associated with the phenotypes IIB.
Background-Familial combined hyperlipidemia (FCHL) is a common hereditary disorder of lipoprotein metabolism estimated to cause 10% to 20% of premature coronary heart disease. We investigated whether functional abnormalities exist in coronary reactivity in asymptomatic patients with FCHL.Methods and Results-We studied 21 male FCHL patients (age, 34.8+/-5.4 years) and a matched group of 21 healthy control subjects. Myocardial blood flow (MBF) was measured at baseline and during dipyridamole-induced hyperemia with PET and O-15-labeled water. The baseline MBF was similar in patients and control subjects (0.79+/-0.19 versus 0.88+/-0.20 mL.g(-1).min(-1), P=NS). An increase in MBF was seen in both groups after dipyridamole infusion, but MBF at maximal vasodilation was lower in FCHL patients (3.54+/-1.59 versus 4.54+/-1.17 mL.g(-1).min(-1), P=0.025). The difference in coronary flow reserve (CFR) was not statistically significant (4.7+/-2.2 versus 5.3+/-1.6, P=NS, patients versus control subjects). Considerable variability in CFR values-was detected within the FCHL group. Patients with phenotype IIB (n=8) bad lower now during hyperemia (2.5+/-1.2versus 4.2+/-1.5 mL.g(-1).min(-1), P<0.05) and lower CFR (3.4+/-2.1 versus 5.4+/-2.0, P<0.05) compared with phenotype IIA (n=13).Conclusions-Abnormalities in coronary flow regulation exist in young asymptomatic FCHL patients expressing phenotype IIB (characterized by abnormalities in both serum cholesterol and triglyceride concentrations). This is in line with previous observations suggesting that the metabolic abnormalities related to the pathophysiology of FCHL are associated with the phenotypes IIB.
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