Change in Coronary Blood Blow and Coronary Blood Flow Reserve after a single High-Fat and Low-Fat Meal in Patients with Ischemic Heart Disease Assessed by Transthoracic Echocardiography

Hyun, Dae Woo; Kim, Kee Sik

Abstract

BACKGROUND AND OBJECTIVES
Transient tirglyceridemia decrease vascular reactivity. The aim of this project is to assess the difference in coronary blood flow and coronary blood flow reserve (CFR) after a single High-Fat (HFM) and a Low-Fat meal (LFM) in patients with ischemic heart disease (IHD). METHOD: We included eleven patients with IHD (mean age : 57.2+/-9.5) and excluded significant lesion of left anterior descending artery (more than 60%). We examined blood pressure, pulse rate, blood glucose, total cholesterol, triglyceride, High density lipoprotein-cholesterol (HDL-C) before and 120 minutes after HFM and LFM. Coronary blood flow and CFR of the left anterior descending artery was determined by transthoracic Doppler echocardiography at the same time. Maximal vasodilating activity was obtained 3 to 5 minutes after adenosine infusion at the rate of 140 ug/kg/min. The percentages of total lipid at HFM and LFM were respectively 64% (513 kcal/803 kcal) and 16% (126 kcal/800 kcal). RESULT: Serum triglyceride increased from 153.0+/-78.7 mg/dL preprandially to 228.5+/-95.4 mg/dL after HFM (p<0.01). Serum triglyceride after HFM was higher than after LFM (166.4+/-67.4 mg/dL, p<0.05). Serum glucose increased from 97.2+/-18.8 mg/dL preprandially after LFM and HFM (152.6+/-38.0 mg/dL, 123.8+/-30.8 mg/dL, p<0.05). Serum glucose after LFM was higher than after HFM (p<0.01). The maximal and mean diastolic velocity of coronary flow at fasting (22.5+/-5.5 cm/sec, 17.8+/-4.3 cm/sec) increased after LFM (25.9+/-5.9 cm/sec, 20.2+/-5.3 cm/sec, p<0.01, p<0.05), and not increased after HFM significantly (24.5+/-4.6 cm/sec, 19.5+/-3.3 cm/sec). The CFR was 2.01+/-0.81 at fasting, 1.97+/-0.72 after LFM and 2.05+/-0.58 after HFM. There was no significant diffterence in CFR related to the diet.
CONCLUSION
In patient with IHD, CFR may not be affected by HFM and LFM. There was increasing tendency of the coronary blood flow after diet, especially by LFM. This is potential mechanism of postprandial angina.