Effects of metabolic syndrome and its components on myocardial microcirculation in obstructive coronary artery disease patients: a cardiac magnetic resonance (CMR) perfusion study
An erratum to this article was published (Cardiovasc Diabetol, 30 Mar 2026 ↗)
Authors' conclusion
MetS aggravated global and non-stenotic coronary territories myocardial microcirculation function impairment in OCAD patients, and MetS, low HDL and obesity were independently associated with impaired myocardial perfusion.
Study context
- Population
- Patients with obstructive coronary artery disease (OCAD) and sex- and age-matched controls127 OCAD, 46 controls
- Participants
- 86 / 41 / 46
- Exposure
- OCAD with metabolic syndrome (MetS) vs OCAD without MetS vs controls
- OCAD (MetS+)n = 86
- OCAD (MetS-)n = 41reference
- Controlsn = 46
- Outcome
- Myocardial microcirculation perfusion by CMR first-pass perfusion (Upslope, MaxSI, TTM, perfusion index (PI)), global and in LAD, LCX and RCA territories
Methodological detailssex- and age-matched controls, CMR first-pass perfusion imaging
- Sex- and age-matched controls
- CMR first-pass perfusion imaging
Main finding
As reported in the abstract
CMR first-pass perfusion parameters
- TTM sequentially prolonged from controls to OCAD (MetS-) to OCAD (MetS+) in global and right coronary artery (RCA) territories (all p < 0.05)
- In OCAD without LCX obstruction, LCX Upslope and max signal intensity (MaxSI) lower with MetS vs non-MetS; similar pattern without RCA obstruction (all P < 0.05)
- OCAD (MetS+) vs OCAD (MetS-): all p < 0.05
- OCAD (MetS+) vs OCAD (MetS-): all p < 0.05
Observational data: associations, not effects.
Further findings
Independent association of MetS with perfusion parameters (multivariable linear regression, adjusted for covariates)
- Upslope (global), β (p < 0.001)
- −0.309
- MaxSI (global), β (p = 0.023)
- −0.200
- TTM (global), β (p = 0.014)
- 0.206
- Upslope (LAD), β (p < 0.001)
- −0.346
- Upslope (LCX), β (p = 0.012)
- −0.214
- Upslope (RCA), β (p = 0.010)
- −0.219
MetS components
- HDL-C and obesity independently associated with Upslope (global) and MaxSI (global)
Original publication
Effects of metabolic syndrome and its components on myocardial microcirculation in obstructive coronary artery disease patients: a CMR perfusion study. Cardiovasc Diabetol. Published 10 December 2025. doi:10.
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