ArticleArthritis research & therapy2013
Prognostic impact of coronary microcirculation abnormalities in systemic sclerosis: a prospective study to evaluate the role of non-invasive tests.
Article in Arthritis research & therapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Coronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis.European heart journal · 2022Pooled it
- Myocardial Infarction With Nonobstructive Coronary Arteries With Coronary Microvascular Dysfunction Associated With Systemic Sclerosis: Case Report.Case reports in vascular medicine · 2026Article
- Non-invasive coronary flow velocity reserve assessment predicts adverse outcome in women with unstable angina without obstructive coronary artery stenosis.Journal of public health research · 2023Article
- The AP-1 transcription factor Fosl-2 drives cardiac fibrosis and arrhythmias under immunofibrotic conditions.Communications biology · 2023Article
- Coronary Flow Velocity Reserve by Echocardiography: Beyond Atherosclerotic Disease.Diagnostics (Basel, Switzerland) · 2023Review
- Coronary Microvascular Dysfunction in Patients With Systemic Lupus Erythematosus and Chest Pain.Frontiers in cardiovascular medicine · 2022Review
- Decreased global myocardial perfusion at adenosine stress as a potential new biomarker for microvascular disease in systemic sclerosis: a magnetic resonance study.BMC cardiovascular disorders · 2018Article
- Cardiovascular Imaging Techniques in Systemic Rheumatic Diseases.Frontiers in medicine · 2018Review
- Population-based analysis of hospitalizations for patients with systemic sclerosis in a West-European region over the period 2001-2012.Rheumatology international · 2016Article
Corrections and comments
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Authors and funding
10 authors.
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Abstract
introductionMicrocirculation dysfunction is a typical feature of systemic sclerosis (SSc) and represents the earliest abnormality of primary myocardial involvement. We assessed coronary microcirculation status by combining two functional tests in SSc patients and estimating its impact on disease outcome.
methodsForty-one SSc patients, asymptomatic for coronary artery disease, were tested for coronary flow velocity reserve (CFR) by transthoracic-echo-Doppler with adenosine infusion (A-TTE) and for left ventricular wall motion abnormalities (WMA) by dobutamine stress echocardiography (DSE). Myocardial multi-detector computed tomography (MDCT) enabled the presence of epicardial stenosis, which could interfere with the accuracy of the tests, to be excluded. Patient survival rate was assessed over a 6.7-±3.5-year follow-up.
resultsNineteen out of 41 (46%) SSc patients had a reduced CFR (≤2.5) and in 16/41 (39%) a WMA was observed during DSE. Furthermore, 13/41 (32%) patients showed pathological CFR and WMA. An inverse correlation between wall motion score index (WMSI) during DSE and CFR value (r=-0.57, P<0.0001) was observed; in addition, CFR was significantly reduced (2.21±0.38) in patients with WMA as compared to those without (2.94±0.60) (P<0.0001). In 12 patients with abnormal DSE, MDCT was used to exclude macrovasculopathy. During a 6.7-±3.5-year follow-up seven patients with abnormal coronary functional tests died of disease-related causes, compared to only one patient with normal tests.
conclusionsA-TTE and DSE tests are useful tools to detect non-invasively pre-clinical microcirculation abnormalities in SSc patients; moreover, abnormal CFR and WMA might be related to a worse disease outcome suggesting a prognostic value of these tests, similar to other myocardial diseases.
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