ArticleJACC. Cardiovascular imaging2021
Impaired Coronary Vasodilator Reserve and Adverse Prognosis in Patients With Systemic Inflammatory Disorders.
Article in JACC. Cardiovascular imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 48 citations in OpenAlex.
- Interplay Between Systemic Inflammation, Myocardial Injury, and Coronary Microvascular Dysfunction in Rheumatoid Arthritis: Results From the LiiRA Study.Journal of the American Heart Association · 2024Trial
- Coronary Flow Velocity Reserve by Stress Echocardiography: The Prognostic Key of Multiple Heart Diseases.Diagnostics (Basel, Switzerland) · 2026Review
- Association of rheumatoid arthritis with major adverse cardiovascular events despite normal myocardial perfusion imaging.American journal of preventive cardiology · 2026Article
- Association between coronary vasomotor dysfunction and autoimmune disease in patients undergoing invasive coronary function testing.International journal of cardiology. Heart & vasculature · 2026Article
- Coronary Microvascular Dysfunction: Epidemiology, Pathophysiology, Diagnosis, and Treatment.MedComm · 2026Review
- Coronary Microvascular Dysfunction and Lipid Molecules: Pathophysiological Mechanisms, Clinical Assessment, and Therapeutic Implications.Journal of personalized medicine · 2026Review
- Coronary microvascular dysfunction in systemic sclerosis: insights from PET-derived myocardial flow reserve.Rheumatology (Oxford, England) · 2026Article
- Coronary microvascular dysfunction in systemic inflammatory diseases: From pathophysiology and prevalence to diagnosis and management.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025Review
- Coronary artery calcium and atherosclerotic cardiovascular disease risk scores in patients with calcium pyrophosphate deposition disease.Rheumatology (Oxford, England) · 2025Article
- Multimodality Imaging in the Diagnosis of Coronary Microvascular Disease: An Update.Journal of personalized medicine · 2025Review
- Emerging Imaging Techniques for Atherosclerosis in Systemic Immune-Mediated Inflammatory Conditions.Arteriosclerosis, thrombosis, and vascular biology · 2025Review
- CAD at the Intersection of Cardiology and Rheumatology: Focus on Cardiovascular Imaging.Methodist DeBakey cardiovascular journal · 2025Review
- The Emerging Specialty of Cardio-Rheumatology.Current atherosclerosis reports · 2024Review
- Novel diagnostic approaches and management of coronary microvascular dysfunction.American journal of preventive cardiology · 2024Article
- Baseline CMR in autoimmune diseases predicts outcome and permits earlier treatment.International journal of cardiology. Heart & vasculature · 2024Article
- The role of comprehensive stress cardiac MRI in autoimmune rheumatic disease: A review.International journal of cardiology. Heart & vasculature · 2024Review
- Comparing various AI approaches to traditional quantitative assessment of the myocardial perfusion in [Scientific reports · 2024Article
- Novel Imaging Approaches to Cardiac Manifestations of Systemic Inflammatory Diseases: JACC Scientific Statement.Journal of the American College of Cardiology · 2023Review
- Future of Radionuclide Myocardial Perfusion Imaging: Transitioning from SPECT to PET.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2023Article
- The future of atherosclerosis assessment: dynamic and quantitative whole-body PET cardiovascular imaging.European journal of nuclear medicine and molecular imaging · 2023Article
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16 authors at 1 institution in 1 country.
Funding
Abstract
objectivesThe purpose of this study was to evaluate the prognostic value of quantitative myocardial blood flow (MBF) and myocardial flow reserve (MFR), reflecting the integrated effects of diffuse atherosclerosis and microvascular dysfunction in patients with systemic inflammatory disorders.
backgroundRheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and psoriasis (PsO) are common inflammatory conditions with excess cardiovascular (CV) risk compared to the general population. Systemic inflammation perturbs endothelial function and has been linked to coronary vasomotor dysfunction. However, the prognostic significance of this vascular dysfunction is not known.
methodsThis was a retrospective study of patients with RA, SLE, and PsO undergoing clinically indicated rest and stress myocardial perfusion positron emission tomography (PET). Patients with an abnormal myocardial perfusion study or left ventricular dysfunction were excluded. MFR was calculated as the ratio of myocardial blood flow (MBF, ml/min/g) at peak stress compared to that at rest.
resultsAmong the 198 patients (median age: 65 years; 80% female), 20.7% had SLE, 31.8% had PsO, and 47.5% had RA. There were no differences in mean MFR between these conditions. Over a median follow-up of 7.8 years, there were 51 deaths and 63 major adverse cardiovascular events (MACE). Patients in the lowest tertile (MFR <1.65) had higher all-cause mortality than the highest tertile, which remained significant after adjusting for age, sex, and the pre-test clinical risk score (hazard ratio [HR]: 2.4; 95% confidence interval [CI]: 1.05 to 5.4; p = 0.038). Similarly, compared to the highest MFR tertile, those in the lowest tertile had a lower MACE-free survival after adjusting for age, sex, and the pre-test clinical risk score (HR: 3.6; 95% CI: 1.7 to 7.6; p = 0.001).
conclusionsIn patients with systemic inflammatory disorders, impaired coronary vasodilator reserve was associated with worse cardiovascular outcomes and all-cause mortality.
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