Decreased global myocardial perfusion at adenosine stress as a potential new biomarker for microvascular disease in systemic sclerosis: a magnetic resonance study.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968539 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2261 (Electronic) Linking ISSN: 14712261 NLM ISO Abbreviation: BMC Cardiovasc Disord Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Coronary Circulation* ; Magnetic Resonance Imaging, Cine* ; Microcirculation*; Adenosine/*administration & dosage ; Heart Diseases/*diagnostic imaging ; Myocardial Perfusion Imaging/*methods ; Scleroderma, Systemic/*complications ; Vasodilator Agents/*administration & dosage; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Cross-Sectional Studies ; Female ; Fibrosis ; Heart Diseases/etiology ; Heart Diseases/physiopathology ; Humans ; Male ; Middle Aged ; Myocardium/pathology ; Predictive Value of Tests ; Scleroderma, Systemic/diagnosis ; Ventricular Remodeling
    • Abstract:
      Background: Patients with systemic sclerosis (SSc) have high cardiovascular mortality even though there is no or little increase in prevalence of epicardial coronary stenosis. First-pass perfusion on cardiovascular magnetic resonance (CMR) have detected perfusion defects indicative of microvascular disease, but the quantitative extent of hypoperfusion is not known. Therefore, we aimed to determine if patients with SSc have lower global myocardial perfusion (MP) at rest or during adenosine stress, compared to healthy controls, quantified with CMR.
      Methods: Nineteen SSc patients (17 females, 61 ± 10 years) and 22 controls (10 females, 62 ± 11 years) underwent CMR. Twelve patients had limited cutaneous SSc and 7 patients had diffuse cutaneous SSc. One patient had pulmonary arterial hypertension (PAH). MP was quantified using coronary sinus flow (CSF) measurements at rest and during adenosine stress, divided by left ventricular mass (LVM).
      Results: There was no difference in MP at rest between patients and controls (1.1 ± 0.5 vs. 1.1 ± 0.3 ml/min/g, P = 0.85) whereas SSc patients showed statistically significantly lower MP during adenosine stress (3.1 ± 0.9 vs. 4.2 ± 1.3 ml/min/g, P = 0.008). Three out of the 19 SSc patients showed fibrosis in the right ventricle insertion points despite absence of PAH. None had signs of myocardial infarction.
      Conclusions: Patients with SSc have decreased MP during adenosine stress compared to healthy controls. Thus hypoperfusion at stress may be a sensitive marker of cardiac disease in SSc patients possibly signifying microvascular myocardial disease.
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    • Contributed Indexing:
      Keywords: Cardiovascular magnetic resonance imaging; Coronary sinus flow; Microvascular disease; Scleroderma; Systemic sclerosis
    • Accession Number:
      0 (Vasodilator Agents)
      K72T3FS567 (Adenosine)
    • Publication Date:
      Date Created: 20180201 Date Completed: 20180725 Latest Revision: 20181113
    • Publication Date:
      20221213
    • Accession Number:
      PMC5791343
    • Accession Number:
      10.1186/s12872-018-0756-x
    • Accession Number:
      29382301