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

Takeshi Hozumi, MD; Marc Eisenberg, MD; Kenichi Sugioka, MD; Aravind R. Kokkirala, MD; Hiroyuki Watanabe, MD; Masakazu Teragaki, MD; Junichi Yoshikawa, MD; and Shunichi Homma, MD
[+] Article and Author 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@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.


Ann Intern Med. 2002;136(7):523-528. doi:10.7326/0003-4819-136-7-200204020-00009
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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.

Figures

Grahic Jump Location
Figure 1.
Spectral Doppler recording in the left anterior descending coronary artery before ( top ) and after ( bottom ) a high-fat meal.

HR = heart rate.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Coronary flow reserve in 15 men who received a high-fat meal ( left ) and in 5 men who received both high- and low-fat meals ( right ).

The 5 men in the right-hand graph are a subset of the 15 men in the left-hand graph.

Grahic Jump Location

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Summary for Patients

How a High-Fat Meal Affects Blood Flow to the Heart

The summary below is from the full report titled “Change in Coronary Flow Reserve on Transthoracic Doppler Echocardiography after a Single High-Fat Meal in Young Healthy Men.” It is in the 2 April 2002 issue of Annals of Internal Medicine (volume 136, pages 523-528). The authors are T Hozumi, M Eisenberg, K Sugioka, AR Kokkirala, H Watanabe, M Teragaki, J Yoshikawa, and S Homma. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.

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