PDF(Pubmed)
Abstract：
UNASSIGNED: Women are disproportionally impacted by ischemia and no obstructive coronary artery disease (INOCA), and such women are at increased risk of developing heart failure with preserved ejection fraction (HFpEF), however the mechanisms linking these conditions remain poorly understood. The aim of this study was to determine whether ultra-high sensitivity cardiac troponin I (u-hscTnI), an indicator of cardiomyocyte injury, is associated with abnormalities in myocardial perfusion and left ventricular (LV) structure and function in women with INOCA.
UNASSIGNED: 327 women with INOCA enrolled in the Women\'s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study underwent vasodilator stress cardiac magnetic resonance imaging (CMRI) and u-hscTnI measurements (Simoa HD-1 Analyzer, Quanterix Corporation). Multivariable linear regression was used to evaluate associations between u-hscTnI concentrations and myocardial perfusion (MPRI), LV mass index and feature-tracking derived strain measures of LV function.
UNASSIGNED: u-hscTnI concentrations were quantifiable in 100% of the cohort and ranged from 0.004 to 79.6 pg/mL. In adjusted models, u-hscTnI was associated with LV mass index (+2.03; 95% CI 1.17, 2.89; p < 0.01) and early diastolic radial strain rate (SR) (+0.13; 95% CI 0.01, 0.25; p = 0.03), early diastolic circumferential SR (-0.04; 95% CI -0.08, 0.002; p = 0.06) and early diastolic longitudinal SR (-0.03; 95% CI -0.07, 0.002; p = 0.06). u-hscTnI was not associated with MPRI (p = 0.39) in adjusted models.
UNASSIGNED: Together, these findings support cardiomyocyte injury as a putative pathway towards adverse LV remodeling and dysfunction; however, further research is needed to define the specific mechanism(s) driving myocellular injury in INOCA.
UNASSIGNED: 327 women with INOCA enrolled in the Women\'s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study underwent vasodilator stress cardiac magnetic resonance imaging (CMRI) and u-hscTnI measurements (Simoa HD-1 Analyzer, Quanterix Corporation). Multivariable linear regression was used to evaluate associations between u-hscTnI concentrations and myocardial perfusion (MPRI), LV mass index and feature-tracking derived strain measures of LV function.
UNASSIGNED: u-hscTnI concentrations were quantifiable in 100% of the cohort and ranged from 0.004 to 79.6 pg/mL. In adjusted models, u-hscTnI was associated with LV mass index (+2.03; 95% CI 1.17, 2.89; p < 0.01) and early diastolic radial strain rate (SR) (+0.13; 95% CI 0.01, 0.25; p = 0.03), early diastolic circumferential SR (-0.04; 95% CI -0.08, 0.002; p = 0.06) and early diastolic longitudinal SR (-0.03; 95% CI -0.07, 0.002; p = 0.06). u-hscTnI was not associated with MPRI (p = 0.39) in adjusted models.
UNASSIGNED: Together, these findings support cardiomyocyte injury as a putative pathway towards adverse LV remodeling and dysfunction; however, further research is needed to define the specific mechanism(s) driving myocellular injury in INOCA.
摘要：
■女性受到缺血和无阻塞性冠状动脉疾病（INOCA）的不成比例的影响，这些女性在射血分数保留（HFpEF）的情况下发生心力衰竭的风险增加，然而，连接这些条件的机制仍然知之甚少。这项研究的目的是确定是否超高敏心肌肌钙蛋白I（u-hscTnI），心肌细胞损伤的指标，与INOCA女性的心肌灌注和左心室（LV）结构和功能异常有关。
■327名患有INOCA的妇女参加了妇女缺血综合征评估-冠状动脉血管功能障碍（WISE-CVD）研究，接受了血管舒张负荷心脏磁共振成像（CMRI）和u-hscTnI测量（SimoaHD-1分析仪，Quanterix公司)。使用多变量线性回归来评估u-hscTnI浓度与心肌灌注（MPRI）之间的关联，LV质量指数和特征跟踪导出的LV功能应变度量。
■u-hscTnI浓度在队列的100%中是可量化的,范围为0.004-79.6pg/mL。在调整后的模型中，u-hscTnI与左心室质量指数(+2.03;95%CI1.17,2.89;p<0.01)和舒张早期径向应变率(SR)(+0.13;95%CI0.01,0.25;p=0.03)相关,舒张早期周向SR(-0.04;95%CI-0.08,0.002;p=0.06)和舒张早期纵向SR(-0.03;95%CI-0.07,0.002;p=0.06)。在校正模型中，u-hscTnI与MPRI无关(p=0.39)。
■一起，这些发现支持心肌细胞损伤是导致左心室不良重塑和功能障碍的推定途径;然而,需要进一步的研究来确定INOCA中驱动心肌细胞损伤的具体机制。
■327名患有INOCA的妇女参加了妇女缺血综合征评估-冠状动脉血管功能障碍（WISE-CVD）研究，接受了血管舒张负荷心脏磁共振成像（CMRI）和u-hscTnI测量（SimoaHD-1分析仪，Quanterix公司)。使用多变量线性回归来评估u-hscTnI浓度与心肌灌注（MPRI）之间的关联，LV质量指数和特征跟踪导出的LV功能应变度量。
■u-hscTnI浓度在队列的100%中是可量化的,范围为0.004-79.6pg/mL。在调整后的模型中，u-hscTnI与左心室质量指数(+2.03;95%CI1.17,2.89;p<0.01)和舒张早期径向应变率(SR)(+0.13;95%CI0.01,0.25;p=0.03)相关,舒张早期周向SR(-0.04;95%CI-0.08,0.002;p=0.06)和舒张早期纵向SR(-0.03;95%CI-0.07,0.002;p=0.06)。在校正模型中，u-hscTnI与MPRI无关(p=0.39)。
■一起，这些发现支持心肌细胞损伤是导致左心室不良重塑和功能障碍的推定途径;然而,需要进一步的研究来确定INOCA中驱动心肌细胞损伤的具体机制。
