Coronary Blood Flow Is Reduced in Patients with Sarcoidosis, Study Finds

Coronary Blood Flow Is Reduced in Patients with Sarcoidosis, Study Finds

Patients with sarcoidosis have lower coronary flow velocity reserve (CFVR), a measure of disturbances in blood flow in heart muscles, compared to healthy volunteers, researchers found.

The study, “Coronary flow reserve is reduced in sarcoidosis,” was published in the journal Atherosclerosis.

CFVR is the maximum increase in blood flow through the coronary arteries above the normal resting flow. Low CFVR indicates that there is coronary microvascular dysfunction, a malfunction in tiny vessels in the heart muscle.

A total of 40 patients with sarcoidosis, age 18 and older, without known atherosclerotic coronary artery disease (a condition in the arteries supplying blood to the heart in which plaque builds up inside the artery walls) or risk factors for atherosclerosis, were enrolled in the study, along with 42 healthy volunteers.

The peak velocity of blood flow was 60.5 in sarcoidosis patients and 68.9 in healthy controls. CFVR was 2.08 in patients and 3.03 in controls. Both measures were thereore lower in patients with sarcoidosis.

Older age and high blood pressure were also found to be associated with a lower CFVR in sarcoidosis patients.

The drop in CFVR seen in patients did not relate to the severity of sarcoidosis, the duration of disease, or the degree of inflammation. Instead, it was associated with the presence of sarcoidosis itself.

“Our findings indicate that the majority of patients with sarcoidosis have an abnormal CFVR and mean CFVR is significantly lower than healthy volunteers, suggesting that an impairment in flow reserve is a common condition in patients with sarcoidosis even when clinically manifest cardiac involvement is not present,” the team wrote.

An abnormal CFVR may indicate a clinically undetectable myocardial involvement (involvement of the heart muscle) in sarcoidosis, the researchers pointed out, stating that poorer health outcomes in patients with sarcoidosis may result from it. However, additional studies are needed.

“Coronary flow velocity reserve is reduced in patients with sarcoidosis even in the absence of risk factors for CAD [coronary artery disease], thus strongly suggesting that coronary microvascular function is disturbed in these patients,” the team concluded, adding that “further studies are needed to elaborate on the mechanisms of microvascular dysfunction in patients with sarcoidosis.”

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3 comments

  1. Sandra says:

    As a patient, it is fascinating to read so many current findings inre: sarcoidosis v. microvascular dysfunction throughout the body. Physicians have become so fixated on non-caseating granulomatous lesions to “validate” a patient’s presentation.

    When I was diagnosed in 2013, there was very little new research going on to explain the seemingly peculiar progression of my disease in the absence of detectable lesions. In my mind and by my reading (and I am no dummy despite what certain big city doctors joke about scaring myself with my Google-Fu), it all fits. Now if I can just get some Cibinetide.

    Seriously though, this research will not compel doctors nor insurance companies to investigate/diagnose/treat microvascular dysfunction as a systemic sarcoid manifestation. Without visible thinning of tissue on a cardiac MRI or a lesion that can be pointed to and deemed a “non-caseating granuloma, my symptoms, while documented, will not be linked by my “team” to sarcoidosis.

    I was laughed at by at least 4 medical staff members at 1 of the best hospitals in the country in 2013. These articles give me hope. The problem is, I cannot seem to position myself within the radius of the right people at the right time – with the right insurance company.

    Are there any plans in the pipeline to treat such microvascular dysfunction with Cibinetide?

    • Janice Nicholls says:

      I hear you Sandra! I was diagnosed in 2013 with Sarcoidosis in the Lungs. I am now having a hard time breathing again, but my Heart is feeling stressed and it pounds out of my chest at night. I am worried sick. My husband is recovering from a Cardiac Arrest and I am worried about me so much now.

  2. Rob Stewart says:

    Would this explain an average resting pulse rate of 95+? If the coronary flow is reduced, would the heart beat faster to compensate?

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