Myocardial Microvascular Dysfunction in Rheumatoid Arthritis Quantitation by 13N-Ammonia Positron Emission Tomography/Computed Tomography

被引:36
作者
Amigues, Isabelle [1 ]
Russo, Cesare [2 ,4 ]
Giles, Jon T. [1 ]
Tugcu, Aylin [2 ,5 ]
Weinberg, Richard [2 ,3 ]
Bokhari, Sabahat [2 ,3 ]
Bathon, Joan M. [1 ]
机构
[1] Columbia Univ, Coll Phys & Surg, New York Presbyterian Hosp, Div Rheumatol, New York, NY 10027 USA
[2] Columbia Univ, Coll Phys & Surg, New York Presbyterian Hospital, Div Cardiol, New York, NY 10027 USA
[3] Columbia Univ, Coll Phys & Surg, New York Presbyterian Hospital, Nucl Cardiol Lab, New York, NY 10027 USA
[4] Novartis Inst BioMed Res, Basel, Switzerland
[5] Bristol Myers Squibb, Lawrenceville, NJ USA
关键词
arthritis; cardiovascular disease; interleukins; perfusion; perfusion imaging; CORONARY FLOW RESERVE; IMPROVES ENDOTHELIAL FUNCTION; LEFT-VENTRICULAR MASS; HEART-FAILURE; ASSOCIATION; DISEASE; QUANTIFICATION; METAANALYSIS; PREDICTOR; MORTALITY;
D O I
10.1161/CIRCIMAGING.117.007495
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: The goal of this study was to assess the prevalence of myocardial microvascular dysfunction in rheumatoid arthritis (RA) patients without clinical cardiovascular disease and its association with RA characteristics and measures of cardiac structure and function. METHODS: Participants with RA underwent rest and vasodilator stress N-13 ammonia positron emission tomography and echocardiography. Global myocardial blood flow was quantified at rest and during peak hyperemia. Myocardial flow reserve (MFR) was calculated as peak stress myocardial blood flow/rest myocardial blood flow. A small number of asymptomatic and symptomatic non-RA controls were also evaluated. RESULTS: In RA patients, mean +/- SD MFR was 2.9 +/- 0.8, with 29% having reduced MFR (<2.5). Male sex and higher interleukin-6 were significantly associated with lower MFR, while the use of tumor necrosis factor inhibitors was associated with higher MFR. Lower MFR was associated with higher left ventricle mass index and higher left ventricle volumes but not with ejection fraction or diastolic dysfunction. RA and symptomatic controls had comparable MFR (mean +/- SD: 2.9 +/- 0.8 versus 2.55 +/- 0.6; P=0.48). In contrast, MFR was higher in the asymptomatic controls (mean +/- SD: 3.25 +/- 0.7) although not statistically different. CONCLUSIONS: Reduced MFR was observed in a third of RA patients without clinical cardiovascular disease and was associated with a measure of inflammation and with higher left ventricle mass and volumes. MFR in RA patients was similar to controls referred for clinical scans (symptomatic controls). Whether reduced MFR contributes to the increased risk for heart failure in RA remains unknown.
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页数:12
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共 48 条
[1]   QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].
AGATSTON, AS ;
JANOWITZ, WR ;
HILDNER, FJ ;
ZUSMER, NR ;
VIAMONTE, M ;
DETRANO, R .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 15 (04) :827-832
[2]   2010 Rheumatoid Arthritis Classification Criteria An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative [J].
Aletaha, Daniel ;
Neogi, Tuhina ;
Silman, Alan J. ;
Funovits, Julia ;
Felson, David T. ;
Bingham, Clifton O., III ;
Birnbaum, Neal S. ;
Burmester, Gerd R. ;
Bykerk, Vivian P. ;
Cohen, Marc D. ;
Combe, Bernard ;
Costenbader, Karen H. ;
Dougados, Maxime ;
Emery, Paul ;
Ferraccioli, Gianfranco ;
Hazes, Johanna M. W. ;
Hobbs, Kathryn ;
Huizinga, Tom W. J. ;
Kavanaugh, Arthur ;
Kay, Jonathan ;
Kvien, Tore K. ;
Laing, Timothy ;
Mease, Philip ;
Menard, Henri A. ;
Moreland, Larry W. ;
Naden, Raymond L. ;
Pincus, Theodore ;
Smolen, Josef S. ;
Stanislawska-Biernat, Ewa ;
Symmons, Deborah ;
Tak, Paul P. ;
Upchurch, Katherine S. ;
Vencovsky, Jiri ;
Wolfe, Frederick ;
Hawker, Gillian .
ARTHRITIS AND RHEUMATISM, 2010, 62 (09) :2569-2581
[3]   Functional Impact of Coronary Stenosis Observed on Coronary Computed Tomography Angiography: Comparison with 13N-Ammonia PET [J].
Alexanderson Rosas, Erick ;
Slomka, Piotr J. ;
Garcia-Rojas, Leonardo ;
Calleja, Rodrigo ;
Jacome, Rodrigo ;
Jimenez-Santos, Moises ;
Romero, Edgar ;
Meave, Aloha ;
Berman, Daniel S. .
ARCHIVES OF MEDICAL RESEARCH, 2010, 41 (08) :642-648
[4]   Diastolic Dysfunction in Rheumatoid Arthritis: A Meta-Analysis and Systematic Review [J].
Aslam, Fawad ;
Bandeali, Salman J. ;
Khan, Nasim A. ;
Alam, Mahboob .
ARTHRITIS CARE & RESEARCH, 2013, 65 (04) :534-543
[5]   Anti-tumour necrosis factor-alpha therapy over conventional therapy improves endothelial function in adults with rheumatoid arthritis [J].
Bilsborough, William ;
Keen, Helen ;
Taylor, Andrew ;
O'Driscoll, Gerard J. ;
Arnolda, Leonard ;
Green, Daniel J. .
RHEUMATOLOGY INTERNATIONAL, 2006, 26 (12) :1125-1131
[6]   Current Understanding of Atherogenesis [J].
Brown, Richard A. ;
Shantsila, Eduard ;
Varma, Chetan ;
Lip, Gregory Y. H. .
AMERICAN JOURNAL OF MEDICINE, 2017, 130 (03) :268-282
[7]   EFFECTS OF DAMAGING THE ENDOCARDIAL SURFACE ON THE MECHANICAL PERFORMANCE OF ISOLATED CARDIAC-MUSCLE [J].
BRUTSAERT, DL ;
MEULEMANS, AL ;
SIPIDO, KR ;
SYS, SU .
CIRCULATION RESEARCH, 1988, 62 (02) :358-366
[8]   Vascular endothelium - Gatekeeper of vessel health [J].
Cahill, Paul A. ;
Redmond, Eileen M. .
ATHEROSCLEROSIS, 2016, 248 :97-109
[9]   Medical progress - Coronary microvascular dysfunction [J].
Camici, Paolo G. ;
Crea, Filippo .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (08) :830-840
[10]   Advances in the Epidemiology of Heart Failure and Left Ventricular Remodeling [J].
Cheng, Susan ;
Vasan, Ramachandran S. .
CIRCULATION, 2011, 124 (20) :E516-E519