Coronary Flow Reserve, Inflammation, and Myocardial Strain: The CIRT-CFR Trial.

冠状动脉血流储备,炎症 ，和心肌应变 ： CI RT - CFR 试验。

• 影响指数: 9.531
• 发表时间: Feb 2023
• 来源期刊: JACC Basic Transl Sci
• DOI: 10.1016/j.jacbts.2022.08.009
• PMID: 36908662
• 文章类型: Journal Article
• 作者列表: Taqueti VR,Shah AM,Everett BM,Pradhan AD,Piazza G,Bibbo C,Hainer J,Morgan V,Carolina do A H de Souza A,Skali H,Blankstein R,Dorbala S,Goldhaber SZ,Le May MR,Chow BJW,deKemp RA,Hage FG,Beanlands RS,Libby P,Glynn RJ,Solomon SD,Ridker PM,Di Carli MF

关键词: BMI, body mass index; CAD, coronary artery disease; CFR, coronary flow reserve; CT, computed tomography; GLS, global longitudinal strain; HDL, high-density lipoprotein cholesterol; HFpEF, heart failure with preserved ejection fraction; IL, interleukin; LDL, low-density lipoprotein cholesterol; LDM, low-dose methotrexate; LVEF, left ventricular ejection fraction; MBF, myocardial blood flow; MI, myocardial infarction; NHLBI, National Heart, Lung, and Blood Institute; NT-proBNP, N-terminal pro–B-type natriuretic peptide; PET, positron emission tomography; cardiometabolic disease; cardiovascular trial coronary flow reserve; coronary microvascular dysfunction; heart failure; hsCRP, high-sensitivity C-reactive protein; hsTNT, high-sensitivity troponin T; inflammation

Abstract

Inflammation is a key determinant of cardiovascular outcomes, but its role in heart failure is uncertain. In patients with cardiometabolic disease enrolled in the prospective, multicenter ancillary study of CIRT (Cardiovascular Inflammation Reduction Trial), CIRT-CFR (Coronary Flow Reserve to Assess Cardiovascular Inflammation), impaired coronary flow reserve was independently associated with increased inflammation and myocardial strain despite well-controlled lipid, glycemic, and hemodynamic profiles. Inflammation modified the relationship between CFR and myocardial strain, disrupting the association between cardiac blood flow and function. Future studies are needed to investigate whether an early inflammation-mediated reduction in CFR capturing microvascular ischemia may lead to heart failure in patients with cardiometabolic disease. (Cardiovascular Inflammation Reduction Trial [CIRT]; NCT01594333; Coronary Flow Reserve to Assess Cardiovascular Inflammation [CIRT-CFR]; NCT02786134).

摘要

炎症是心血管结局的关键决定因素，但其在心力衰竭中的作用尚不确定。在前瞻性的心脏代谢疾病患者中，CIRT(心血管炎症减少试验)的多中心辅助研究，CIRT-CFR（评估心血管炎症的冠状动脉血流储备），尽管血脂控制良好,但冠状动脉血流储备受损与炎症和心肌应变增加独立相关,血糖，和血液动力学曲线。炎症改变了CFR与心肌劳损的关系,破坏心脏血流和功能之间的联系。需要进一步的研究来研究早期炎症介导的CFR捕获微血管缺血的减少是否可能导致心脏代谢疾病患者的心力衰竭。(心血管炎症减少试验[CIRT];NCT01594333;评估心血管炎症的冠状动脉血流储备[CIRT-CFR];NCT02786134)。