Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Maturitas. 2018 Jan;107:110-115. doi: 10.1016/j.maturitas.2017.07.004. Epub 2017 Aug 12.
Reproductive risk factors such as preeclampsia and recurrent miscarriages have been associated with adverse cardiovascular (CV) events. Underlying coronary microvascular dysfunction (CMD) may be a common denominator.
We investigated whether a history of reproductive risk factors was associated with CMD in women with angina pectoris and no obstructive coronary artery disease (CAD).
Participants from the iPOWER study, including women with angina pectoris and no obstructive CAD (<50% stenosis), were invited to complete an electronic survey regarding reproductive risk factors: recurrent miscarriages, gestational diabetes, preeclampsia, rhesus immunity, polycystic ovary syndrome and menopausal status as well as migraine and Raynaud phenomenon. CMD was assessed by transthoracic Doppler echocardiography with measurement of coronary flow velocity reserve (CFVR) during high-dose dipyridamole infusion, and analyzed in three categories with cut-off points at 2.0 and 2.5. Associations between CFVR and a history of reproductive risk factors were examined by age-adjusted trend test.
The questionnaire was completed by 613 women (73% of those invited), of whom 550 had a successful CFVR measurement. There was no significant difference in baseline characteristics between participants and non-participants. Median (interquartile range (IQR)) age was 62.8 (54.8; 68.7) years, median (IQR) BMI 26.2 (23.2; 29.8) kg/m, and 81.5% were postmenopausal. We did not find any significant associations between any of the reproductive risk factors, Raynaud's phenomenon or migraine and CFVR.
The lack of association between coronary microvascular function and a history of reproductive risk factors, migraine and Raynaud's phenomenon suggests that a common vascular pathophysiological mechanism underlying these conditions is unlikely.
子痫前期和反复流产等生殖风险因素与不良心血管（CV）事件有关。潜在的冠状动脉微血管功能障碍（CMD）可能是一个共同的决定因素。
我们研究了在患有心绞痛且无阻塞性冠状动脉疾病（CAD）的女性中，生殖风险因素史是否与 CMD 相关。
来自 iPOWER 研究的参与者，包括患有心绞痛且无阻塞性 CAD（<50%狭窄）的女性，被邀请完成一份关于生殖风险因素的电子调查问卷：反复流产、妊娠糖尿病、子痫前期、Rh 免疫、多囊卵巢综合征和绝经状态，以及偏头痛和雷诺现象。CMD 通过高剂量双嘧达莫输注时的经胸多普勒超声心动图评估，并根据 2.0 和 2.5 的截断值分为三个类别进行分析。通过年龄调整趋势检验检查 CFVR 与生殖风险因素史之间的关联。
共有 613 名女性（邀请人数的 73%）完成了问卷，其中 550 名女性 CFVR 测量成功。参与者和非参与者的基线特征无显著差异。中位（四分位距（IQR））年龄为 62.8（54.8；68.7）岁，中位（IQR）BMI 为 26.2（23.2；29.8）kg/m2，81.5%为绝经后。我们没有发现任何生殖风险因素、雷诺现象或偏头痛与 CFVR 之间存在任何显著关联。
CFVR 与生殖风险因素、偏头痛和雷诺现象史之间缺乏关联表明，这些疾病的潜在血管病理生理机制不太可能相同。
