Chronic inflammation and impaired coronary vasoreactivity in patients with coronary risk factors

Thomas H. Schindler, Egbert U. Nitzsche, Manfred Olschewski, Nobuhisa Magosaki, Michael Mix, John O. Prior, Alvaro D. Facta, Ulrich Solzbach, Hanjoerg Just, Heinrich R. Schelbert

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Background - The goal of this study was to examine a possible association between systemic microinflammation, as reflected by C-reactive protein (CRP) serum levels, and coronary vasomotion in patients with coronary risk factors but with angiographically normal coronary arteries. Methods and Results - Coronary vasomotor function was studied in response to cold pressor testing (CPT) in 71 patients with normal angiograms. In all patients, CPT-induced changes in epicardial luminal area (LA; mm2) were assessed with quantitative angiography. Within 20 days, myocardial blood flow (MBF) responses to CPT were measured (mL · g-1 · min-1) noninvasively with 13N-ammonia and PET imaging. The CPT-induced mean changes in LA and in MBF in patients with elevated CRP (≥0.5 mg/dL) were significantly impaired compared with patients presenting with CRP levels within normal range (<0.5 mg/dL) (ΔLA, - 1.09±0.86 versus 0.45±0.63 mm 2; ΔMBF, 0.06±0.18 versus 0.44±0.31 mL · g-1 · min-1; P<0.0001, respectively). Coronary LA changes and MBF responses to CPT were inversely correlated with CRP serum levels (r=-0.84 and r=-0.63; P<0.0001). Lastly, regression analysis revealed a significant correlation between the changes in LA and MBF during CPT for patients with elevated CRP levels and those for patients with normal CRP levels (r=0.56 and r=0.66; P<0.001). Conclusions - These findings suggest a direct association between systemic microinflammation and altered coronary vasomotor function of both the epicardial conductance and the arteriolar resistance vessels.

Original languageEnglish
Pages (from-to)1069-1075
Number of pages7
Issue number9
StatePublished - Aug 31 2004


  • Blood flow
  • C-reactive protein
  • Coronary disease
  • Endothelium
  • Inflammation


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