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Autoimmune rheumatic diseases in women with coronary microvascular dysfunction: a report from the Women's Ischemia

Melanie T Chen1, Joseph Chang1, Ashley S Manchanda1

  • 1Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United States.

Frontiers in Cardiovascular Medicine
|June 16, 2023
PubMed

Insights

Women with autoimmune rheumatic diseases (ARDs) and coronary microvascular dysfunction (CMD) experience worse functional status and myocardial perfusion. This highlights a need for further research into ARD

Area of Science:

  • Cardiology
  • Rheumatology
  • Vascular Biology

Background:

  • Autoimmune rheumatic diseases (ARDs) are linked to coronary microvascular dysfunction (CMD).
  • The impact of ARDs on CMD in women with ischemia and no obstructive arteries (INOCA) is not well understood.
  • This study investigates the relationship between ARD history and CMD outcomes in women with INOCA.

Purpose of the Study:

  • To determine if women with CMD and a history of ARD have increased angina, functional limitations, and myocardial perfusion compromise.
  • To compare outcomes in women with CMD, stratified by the presence or absence of ARD history.

Main Methods:

  • Utilized data from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) project.
  • Included women with INOCA and confirmed CMD via invasive coronary function testing.
  • Assessed Seattle Angina Questionnaire (SAQ), Duke Activity Status Index (DASI), and cardiac magnetic resonance myocardial perfusion reserve index (MPRI).

Main Results:

  • Of 207 women with CMD, 19 (9%) had a history of ARD.
  • Women with ARD were younger, had lower DASI scores (functional status), and lower MPRI (myocardial perfusion reserve).
  • A trend towards increased nocturnal and stress-induced angina was observed in women with ARD.

Conclusions:

  • Women with CMD and ARD history exhibit poorer functional status and myocardial perfusion reserve.
  • Angina symptoms and invasive coronary function did not significantly differ between groups.
  • Further research is needed to elucidate mechanisms of CMD in women with ARDs and INOCA.
Abstract

Keywords:
autoimmune rheumatic diseaseschest paincoronary microvascular dysfunctioncoronary vasospasmischemic heart disease

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