Vascular health and risk management · 2026
Lipidomic Profiling and Biological Aging in Patients with Coronary Microvascular Dysfunction.
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Lu Danbo, Deng Lixiang, Wang Zhe, Hu Yiqing, Pan Congcong, Lu Hao, Zhou You
Аннотация
BACKGROUND: Coronary microvascular dysfunction (CMD) was frequently encountered in patients with angina in the absence of epicardial coronary stenosis. CMD was associated with adverse outcomes while the etiology was unclear.
OBJECTIVE: In this study, we aimed to investigate the association between lipidomic abnormalities, biological aging and CMD.
METHODS: We consecutively enrolled 43 patients with angina exhibiting no epicardial coronary stenosis on angiography. CMD was defined by a coronary angiography-derived index of microvascular resistance (caIMR) >25. Targeted lipidomic profiling quantified 781 lipids. PhenoAge was calculated from clinical parameters. Using machine learning, lipidomic data and clinical characteristics were screened to identify candidate biomarkers.
RESULTS: There were 25 patients having CMD with the mean caIMR of 34.0 (Interquartile range [IQR], 31.0-36.5), in contrast to 23.0 (IQR, 19.0-24.5) in the control group. Patients with CMD had substantially older PhenoAge (61 vs 52, p = 0.002). Forty-eight lipid species were dysregulated in patients with CMD, which predominantly belonged to triacylglycerol (TAG). PhenoAge, triglyceride glucose index, hypertension, TAG47:2-FA14:0, TAG48:4-FA18:1 and phosphatidylcholine (18:1/20:3) were independent risk factors of CMD. Incorporating dysregulated lipids significantly improved CMD prediction compared to traditional clinical factors alone (area under the curve, 0.94 vs 0.86, p < 0.05).
CONCLUSION: PhenoAge acceleration and dysregulated lipidome were associated with CMD. Larger-scale studies and external validation are needed in the future.
OBJECTIVE: In this study, we aimed to investigate the association between lipidomic abnormalities, biological aging and CMD.
METHODS: We consecutively enrolled 43 patients with angina exhibiting no epicardial coronary stenosis on angiography. CMD was defined by a coronary angiography-derived index of microvascular resistance (caIMR) >25. Targeted lipidomic profiling quantified 781 lipids. PhenoAge was calculated from clinical parameters. Using machine learning, lipidomic data and clinical characteristics were screened to identify candidate biomarkers.
RESULTS: There were 25 patients having CMD with the mean caIMR of 34.0 (Interquartile range [IQR], 31.0-36.5), in contrast to 23.0 (IQR, 19.0-24.5) in the control group. Patients with CMD had substantially older PhenoAge (61 vs 52, p = 0.002). Forty-eight lipid species were dysregulated in patients with CMD, which predominantly belonged to triacylglycerol (TAG). PhenoAge, triglyceride glucose index, hypertension, TAG47:2-FA14:0, TAG48:4-FA18:1 and phosphatidylcholine (18:1/20:3) were independent risk factors of CMD. Incorporating dysregulated lipids significantly improved CMD prediction compared to traditional clinical factors alone (area under the curve, 0.94 vs 0.86, p < 0.05).
CONCLUSION: PhenoAge acceleration and dysregulated lipidome were associated with CMD. Larger-scale studies and external validation are needed in the future.