TY - JOUR
T1 - Chronic inflammation and coronary microvascular dysfunction in patients without risk factors for coronary artery disease
AU - Recio-Mayoral, Alejandro
AU - Mason, Justin C.
AU - Kaski, Juan C.
AU - Rubens, Michael B.
AU - Harari, Olivier A.
AU - Camici, Paolo G.
PY - 2009/8
Y1 - 2009/8
N2 - AimsTo demonstrate that exposure to chronic inflammation results in coronary microvascular dysfunction (CMD).Methods and resultsUsing positron emission tomography, resting and hyperaemic (adenosine, 140 g/kg/min) myocardial blood flow (MBF) was measured in 25 patients with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). Coronary flow reserve (CFR) was calculated as adenosine/resting MBF. Patients had normal or minimally diseased (i.e. ≤20 luminal diameter) coronary arteries at angiography and no cardiovascular risk factors. Twenty five age- and gender-matched healthy volunteers served as controls. Resting MBF was similar in patients and controls (1.25 ± 0.27 vs. 1.15 ± 0.24 mL/min/g; P = 0.15) while patients had lower hyperaemic MBF (2.94 ± 0.83 vs. 4.11 ± 0.84 mL/min/g; P <0.001) and CFR (2.44 ± 0.78 vs. 3.81 ± 1.07; P <0.001). CFR was inversely related to disease duration (r = -0.65; P <0.001) and SLE disease activity (r = -0.69; P = 0.01). Seven patients showed ischaemic electrocardiographic changes during adenosine. They had longer disease duration (21 ± 7 vs. 14 ± 5 years; P = 0.03) and lower CFR (1.76 ± 0.81 vs. 2.49 ± 0.54; P = 0.006) when compared with patients without changes.
AB - AimsTo demonstrate that exposure to chronic inflammation results in coronary microvascular dysfunction (CMD).Methods and resultsUsing positron emission tomography, resting and hyperaemic (adenosine, 140 g/kg/min) myocardial blood flow (MBF) was measured in 25 patients with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). Coronary flow reserve (CFR) was calculated as adenosine/resting MBF. Patients had normal or minimally diseased (i.e. ≤20 luminal diameter) coronary arteries at angiography and no cardiovascular risk factors. Twenty five age- and gender-matched healthy volunteers served as controls. Resting MBF was similar in patients and controls (1.25 ± 0.27 vs. 1.15 ± 0.24 mL/min/g; P = 0.15) while patients had lower hyperaemic MBF (2.94 ± 0.83 vs. 4.11 ± 0.84 mL/min/g; P <0.001) and CFR (2.44 ± 0.78 vs. 3.81 ± 1.07; P <0.001). CFR was inversely related to disease duration (r = -0.65; P <0.001) and SLE disease activity (r = -0.69; P = 0.01). Seven patients showed ischaemic electrocardiographic changes during adenosine. They had longer disease duration (21 ± 7 vs. 14 ± 5 years; P = 0.03) and lower CFR (1.76 ± 0.81 vs. 2.49 ± 0.54; P = 0.006) when compared with patients without changes.
KW - Coronary circulation
KW - Inflammation
KW - Myocardial blood flow
KW - Positron emission tomography
KW - Rheumatoid arthritis
KW - Systemic lupus erythematosus
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U2 - 10.1093/eurheartj/ehp205
DO - 10.1093/eurheartj/ehp205
M3 - Article
C2 - 19502228
AN - SCOPUS:68749087307
VL - 30
SP - 1837
EP - 1843
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 15
ER -