Change in Coronary Flow Reserve on Transthoracic Doppler Echocardiography after a Single High-Fat Meal in Young Healthy Men

2 April 2002 | Volume 136 Issue 7 | Pages 523-528

Background: High-fat meals and elevated triglyceride levels are associated with cardiovascular disease. In recent studies of brachial artery vasoactivity, a single high-fat meal reduced endothelial function in young healthy men. It is unknown whether coronary microcirculation is affected after high-fat meals.

Objective: To evaluate change in coronary flow reserve after a single high-fat meal.

Design: Controlled interventional study.

Setting: University hospitals.

Patients: 15 young healthy men (mean age [±SD], 29 ± 4 years).

Intervention: Coronary flow reserve was determined by using transthoracic Doppler echocardiography before and after consumption of a high-fat meal in all 15 men and before and after consumption of a low-fat meal in 5 of 15 men.

Measurements: Coronary flow reserve, lipid levels, and hemodynamic characteristics.

Results: In all men, triglyceride levels increased significantly from baseline 5 hours after the high-fat meal, from 1.1 mmol/L to 2.8 mmol/L (100 mg/dL to 250 mg/dL) (P < 0.001). Average coronary flow reserve was 4.02 before and 3.30 5 hours after the high-fat meal (decrease, 18% [95% CI, 13% to 23%]). In the 5 men who received both meals, mean coronary flow reserve decreased by 0.79 after the high-fat meal and increased by 0.07 after the low-fat meal (difference, –0.86 [CI, –1.36 to –0.37]; P = 0.03). Mean triglyceride levels increased by 1.6 mmol/L (140 mg/dL) after the high-fat meal and 0.1 mmol/L (10 mg/dL) after the low-fat meal (difference, 1.5 mmol/L [CI, 0.3 to 2.7 mmol/L], 130 mg/dL [CI, 23 to 236 mg/dL]; P = 0.03).

Conclusions: Coronary flow reserve decreased after a single high-fat meal in young healthy men. High-fat meals may be detrimental to coronary microcirculation.

Editors' Notes Context Some studies show that acute elevations in plasma triglyc-eride levels after a high-fat meal alter vascular tone and impair endothelial function. Whether a high-fat meal and associated hypertriglyceridemia affect coronary microcirculation in healthy people without known cardiovascular disease is unclear. Contribution Five hours after a single high-fat meal, triglyceride levels in 15 healthy young men increased from 1.1 mmol/L to 2.8 mmol/L (100 mg/dL to 250 mg/dL) and coronary flow reserve decreased by 18% (95% CI, 13% to 23%). Implications A single high-fat meal can adversely affect coronary micro-circulation in young healthy men. –The Editors

 

Author and Article Information

From Columbia University, New York, New York; and Osaka City University Medical School, Osaka, Japan.

Acknowledgment: The authors thank Robert Siacca, EngScD, for statistical assistance.

Grant Support: In part by the Council for Research Resources (RR-00645).

Requests for Single Reprints: Takeshi Hozumi, MD, First Department of Internal Medicine, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan; e-mail, thozumi{at}med.osaka-cu.ac.jp.

Current Author Addresses: Drs. Hozumi, Watanabe, Teragaki, and Yoshikawa: First Department of Internal Medicine, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.

Drs. Eisenberg, Sugioka, Kokkirala, and Homma: PH9-941, Division of Cardiology, Columbia University, 630 West 168th Street, New York, NY 10032.

Author Contributions: Conception and design: T. Hozumi, J. Yoshikawa, S. Homma.

Analysis and interpretation of the data: T. Hozumi, K. Sugioka, H. Watanabe, M. Teragaki.

Drafting of the article: T. Hozumi, J. Yoshikawa, S. Homma.

Critical revision of the article for important intellectual content: T. Hozumi, K. Sugioka, J. Yoshikawa, S. Homma.

Final approval of the article: T. Hozumi, M. Eisenberg, K. Sugioka, A.R. Kokkirala, H. Watanabe, M. Teragaki, J. Yoshikawa, S. Homma.

Provision of study materials or patients: T. Hozumi, M. Eisenberg, K. Sugioka, A.R. Kokkirala, M. Teragaki.

Statistical expertise: T. Hozumi, S. Homma.

Obtaining of funding: S. Homma.

Administrative, technical, or logistic support: J. Yoshikawa, S. Homma.

Collection and assembly of data: T. Hozumi, M. Eisenberg, K. Sugioka, A.R. Kokkirala, H. Watanabe, M. Teragaki.