Sex differences in coronary microvascular resistance measured by a computational fluid dynamics model

Daniel J Taylor; Louise Aubiniere-Robb; Rebecca Gosling; Tom Newman; D Rodney Hose; Ian Halliday; Patricia V Lawford; Andrew J Narracott; Julian P Gunn; Paul D Morris

doi:10.3389/fcvm.2023.1159160

Sex differences in coronary microvascular resistance measured by a computational fluid dynamics model

Front Cardiovasc Med. 2023 Jul 6:10:1159160. doi: 10.3389/fcvm.2023.1159160. eCollection 2023.

Authors

Daniel J Taylor^#¹, Louise Aubiniere-Robb^#¹, Rebecca Gosling^{1

2

3}, Tom Newman^{1

2}, D Rodney Hose^{1

3}, Ian Halliday^{1

3}, Patricia V Lawford^{1

3}, Andrew J Narracott^{1

3}, Julian P Gunn^{1

2

3}, Paul D Morris^{1

2

3}

Affiliations

¹ Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.
² Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
³ Insigneo Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom.

^# Contributed equally.

Abstract

Background: Increased coronary microvascular resistance (CMVR) is associated with coronary microvascular dysfunction (CMD). Although CMD is more common in women, sex-specific differences in CMVR have not been demonstrated previously.

Aim: To compare CMVR between men and women being investigated for chest pain.

Methods and results: We used a computational fluid dynamics (CFD) model of human coronary physiology to calculate absolute CMVR based on invasive coronary angiographic images and pressures in 203 coronary arteries from 144 individual patients. CMVR was significantly higher in women than men (860 [650-1,205] vs. 680 [520-865] WU, Z = -2.24, p = 0.025). None of the other major subgroup comparisons yielded any differences in CMVR.

Conclusion: CMVR was significantly higher in women compared with men. These sex-specific differences may help to explain the increased prevalence of CMD in women.

Keywords: computational fluid dynamics; coronary microvascular dysfunction; coronary microvascular resistance; coronary physiology; sex.

Grants and funding

PM was funded by the Wellcome Trust (214567/Z/18/Z). For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. RG was supported by a National Institute for Health and Care Research UK Clinical Lectureship. This independent research was carried out at the National Institute for Health and Care Research (NIHR) Sheffield Biomedical Research Centre (NIHR203321). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.