Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) project
BackgroundWhile autoimmune rheumatic diseases (ARDs) have been linked with coronary microvascular dysfunction (CMD), the relationship between ARD and CMD in women with signs and symptoms of ischemia and no obstructive arteries (INOCA) are not well described. We hypothesized that among women with CMD...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1155914/full |
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| author | Melanie T. Chen Joseph Chang Ashley S. Manchanda Galen Cook-Wiens Chrisandra L. Shufelt R. David Anderson John W. Petersen Dhaval R. Naik Louise E. J. Thomson Daniel S. Berman Eileen M. Handberg Carl J. Pepine C. Noel Bairey Merz Janet Wei |
| author_facet | Melanie T. Chen Joseph Chang Ashley S. Manchanda Galen Cook-Wiens Chrisandra L. Shufelt R. David Anderson John W. Petersen Dhaval R. Naik Louise E. J. Thomson Daniel S. Berman Eileen M. Handberg Carl J. Pepine C. Noel Bairey Merz Janet Wei |
| author_sort | Melanie T. Chen |
| collection | DOAJ |
| description | BackgroundWhile autoimmune rheumatic diseases (ARDs) have been linked with coronary microvascular dysfunction (CMD), the relationship between ARD and CMD in women with signs and symptoms of ischemia and no obstructive arteries (INOCA) are not well described. We hypothesized that among women with CMD, those with ARD history have greater angina, functional limitations, and myocardial perfusion compromise compared to those without ARD history.MethodsWomen with INOCA and confirmed CMD by invasive coronary function testing were included from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) project (NCT00832702). Seattle Angina Questionnaire (SAQ), Duke Activity Status Index (DASI), and cardiac magnetic resonance myocardial perfusion reserve index (MPRI) were collected at baseline. Chart review was performed to confirm self-reported ARD diagnosis.ResultsOf the 207 women with CMD, 19 (9%) had a confirmed history of ARD. Compared to those without ARD, women with ARD were younger (p = 0.04). In addition, they had lower DASI-estimated metabolic equivalents (p = 0.03) and lower MPRI (p = 0.008) but similar SAQ scores. There was a trend towards increased nocturnal angina and stress-induced angina in those with ARD (p = 0.05 for both). Invasive coronary function variables were not significantly different between groups.ConclusionsAmong women with CMD, women with a history of ARD had lower functional status and worse myocardial perfusion reserve compared to women without ARD. Angina-related health status and invasive coronary function were not significantly different between groups. Further studies are warranted to understand mechanisms contributing to CMD among women with ARDs with INOCA. |
| first_indexed | 2024-03-13T08:18:07Z |
| format | Article |
| id | doaj.art-d9dedb24b00e49209d4e90e8e664b774 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-13T08:18:07Z |
| publishDate | 2023-05-01 |
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| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-d9dedb24b00e49209d4e90e8e664b7742023-05-31T14:08:10ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-05-011010.3389/fcvm.2023.11559141155914Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) projectMelanie T. Chen0Joseph Chang1Ashley S. Manchanda2Galen Cook-Wiens3Chrisandra L. Shufelt4R. David Anderson5John W. Petersen6Dhaval R. Naik7Louise E. J. Thomson8Daniel S. Berman9Eileen M. Handberg10Carl J. Pepine11C. Noel Bairey Merz12Janet Wei13Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United StatesBarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United StatesBarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United StatesBiostatistics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, United StatesDivision of Internal Medicine, Women's Health Research Center, Mayo Clinic, Jacksonville, FL, United StatesDivision of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL, United StatesDivision of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL, United StatesDivision of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL, United StatesMark S. Taper Imaging Center, Cedars-Sinai Medical Center, Los Angeles, CA, United StatesMark S. Taper Imaging Center, Cedars-Sinai Medical Center, Los Angeles, CA, United StatesDivision of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL, United StatesDivision of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL, United StatesBarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United StatesBarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United StatesBackgroundWhile autoimmune rheumatic diseases (ARDs) have been linked with coronary microvascular dysfunction (CMD), the relationship between ARD and CMD in women with signs and symptoms of ischemia and no obstructive arteries (INOCA) are not well described. We hypothesized that among women with CMD, those with ARD history have greater angina, functional limitations, and myocardial perfusion compromise compared to those without ARD history.MethodsWomen with INOCA and confirmed CMD by invasive coronary function testing were included from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) project (NCT00832702). Seattle Angina Questionnaire (SAQ), Duke Activity Status Index (DASI), and cardiac magnetic resonance myocardial perfusion reserve index (MPRI) were collected at baseline. Chart review was performed to confirm self-reported ARD diagnosis.ResultsOf the 207 women with CMD, 19 (9%) had a confirmed history of ARD. Compared to those without ARD, women with ARD were younger (p = 0.04). In addition, they had lower DASI-estimated metabolic equivalents (p = 0.03) and lower MPRI (p = 0.008) but similar SAQ scores. There was a trend towards increased nocturnal angina and stress-induced angina in those with ARD (p = 0.05 for both). Invasive coronary function variables were not significantly different between groups.ConclusionsAmong women with CMD, women with a history of ARD had lower functional status and worse myocardial perfusion reserve compared to women without ARD. Angina-related health status and invasive coronary function were not significantly different between groups. Further studies are warranted to understand mechanisms contributing to CMD among women with ARDs with INOCA.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1155914/fullautoimmune rheumatic diseasescoronary microvascular dysfunctioncoronary vasospasmchest painischemic heart disease |
| spellingShingle | Melanie T. Chen Joseph Chang Ashley S. Manchanda Galen Cook-Wiens Chrisandra L. Shufelt R. David Anderson John W. Petersen Dhaval R. Naik Louise E. J. Thomson Daniel S. Berman Eileen M. Handberg Carl J. Pepine C. Noel Bairey Merz Janet Wei Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) project Frontiers in Cardiovascular Medicine autoimmune rheumatic diseases coronary microvascular dysfunction coronary vasospasm chest pain ischemic heart disease |
| title | Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) project |
| title_full | Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) project |
| title_fullStr | Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) project |
| title_full_unstemmed | Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) project |
| title_short | Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia Syndrome Evaluation—Coronary Vascular Dysfunction (WISE-CVD) project |
| title_sort | autoimmune rheumatic diseases in women with coronary microvascular dysfunction a report from the women s ischemia syndrome evaluation coronary vascular dysfunction wise cvd project |
| topic | autoimmune rheumatic diseases coronary microvascular dysfunction coronary vasospasm chest pain ischemic heart disease |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1155914/full |
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