Ingeborg Eskerud‘s PhD thesis gives new knowledge about possible causes of myocardial ischemia in persons with non-obstructive coronary artery disease.
- Total plaque burden associates with myocardial perfusion independent of having large coronary stenoses.
- Left ventricular hypertrophy could contribute to stress-induced myocardial ischemia in non-obstructive heart patients with stable angina.
- Aortic stiffness is also linked to stress-induced myocardial ischemia and larger extent of ischemia in this patient group.
Thesis: Myocardial ischemia in non-obstructive coronary artery disease
Candidate: Ingeborg Eskerud
Time: September 22, 2020 at 12:15
Place: Online-based solution, due to the covid-19 situation
Link to university website (in Norwegian)
(1) Women with NSTEMI more often have non-obstructive coronary heart disease, but the total plaque burden is similar to men. The higher burden of coronary artery plaques, the higher is the risk of having severe myocardial hypoperfusion, and this association is independent of presence of significant coronary stenoses.
The researchers have assessed coronary artery plaque area and myocardial perfusion in 108 patients, of which 35 were women. Compared to 91% of the men, only 74% of the female patients had ≥50% coronary artery stenosis.
(2/3) Patients with stable angina and non-obstructive coronary artery disease are more likely to get stress-induced myocardial ischemia if they also have left ventricular hypertrophy. Higher aortic stiffness is also independently linked to stress-induced myocardial ischemia. Moreover, both left ventricular hypertrophy and aortic stiffness associate with larger extent of ischemia in these patients..
The studies include 125 and 132 patients, of which approximately 50% had myocardial ischemia during stress echocardiography.
(1) Eskerud, I., Gerdts, E., Nordrehaug, J. E., & Lønnebakken, M. T. (2015). Global coronary artery plaque area is associated with myocardial hypoperfusion in women with non-ST elevation myocardial infarction. Journal of Women’s Health, 24(5), 367-373.
(2) Lønnebakken, M. T., Eskerud, I., Larsen, T. H., Midtbø, H. B., Kokorina, M. V., & Gerdts, E. (2019). Impact of aortic stiffness on myocardial ischaemia in non-obstructive coronary artery disease. Open Heart, 6(1), e000981.
(3) Eskerud, I., Gerdts, E., Larsen, T. H., & Lønnebakken, M. T. (2019). Left ventricular hypertrophy contributes to Myocardial Ischemia in Non-obstructive Coronary Artery Disease (the MicroCAD study). International Journal of Cardiology, 286, 1-6.