1346Laser doppler assessment of dermal microcirculatory endothelial function in patients with angina and non-obstructive coronary arteries

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Introduction: Coronary endothelial dysfunction plays a major role in the development of atherosclerotic coronary artery disease and has been associated with an increased risk of cardiac events. Laser Doppler flow (LDF) is a simple non-invasive optical-based method for assessing blood flow in the subcutaneous blood vessels, including endothelium-dependent vasodilation by utilising iontophoretically administered acetylcholine (ACh). Objective: This study aims to determine if there is an association between coronary and skin microvascular endothelium-dependent vasodilatory responses in patients with angina and no obstructive coronary disease (NoCAD). Methods: Patients with angina and NoCAD i.e no stenosis ≥50%, underwent comprehensive invasive coronary haemodynamic testing after discontinuation of vasodilating drugs. Coronary endothelial function was determined by assessing responses to low dose intracoronary acetylcholine (IC-ACh) infusion (0.18mcg/min & 1.8mcg/min) over 2min respectively in left anterior descending artery (LAD). Skin microvascular endothelial function was assessed using LDF assessed blood flow responses to ACh iontophoresis. Results: Of the 41 patients (81% female, mean age of 54±11) recruited for invasive coronary haemodynamic testing, 19 (46.3%) patients had coronary endothelial dysfunction defined as no dilatation or constriction from baseline post IC-ACh infusions. Dermal microcirculation vasodilatory response determined by peak perfusion ratio (PPR) and percentage relative change in perfusion from baseline (PRCB); to ACh iontophoresis stimulus was significantly attenuated in patients with coronary endothelial dysfunction. (PPR Mean ± S.D; 16.0±5.4 vs 21.2±9.4; P=0.04) & (PRCB Mean ± S.D; 1504.8±538.0 vs 2025.6±941.8; P=0.04)

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