{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:57:08Z","timestamp":1791266228805,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Coronary microvascular dysfunction has been described in patients with autoimmune rheumatic disease (ARD). However, it is unknown whether positron emission tomography (PET)-derived myocardial flow reserve (MFR) can predict adverse events in this population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              Patients with ARD without coronary artery disease who underwent dynamic rest-stress\n              <jats:sup>82<\/jats:sup>\n              Rubidium PET were retrospectively studied and compared with patients without ARD matched for age, sex, and comorbidities. The association between MFR and a composite end point of mortality or myocardial infarction or heart failure admission was evaluated with time to event and Cox-regression analyses.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>In 101 patients with ARD (88% female, age: 62\u00b110 years), when compared with matched patients without ARD (n=101), global MFR was significantly reduced (median: 1.68 [interquartile range: 1.34\u20132.05] versus 1.86 [interquartile range: 1.58\u20132.28]) and reduced MFR (&lt;1.5) was more frequent (40% versus 22%). MFR did not differ among subtypes of ARDs. In survival analysis, patients with ARD and low MFR (MFR&lt;1.5) had decreased event-free survival for the combined end point, when compared with patients with and without ARD and normal MFR (MFR&gt;1.5) and when compared with patients without ARD and low MFR, after adjustment for the nonlaboratory-based Framingham risk score, rest left ventricular ejection fraction, severe coronary calcification, and the presence of medium\/large perfusion defects. In Cox-regression analysis, ARD diagnosis and reduced MFR were both independent predictors of adverse events along with congestive heart failure diagnosis and presence of medium\/large stress perfusion defects on PET. Further analysis with inclusion of an interaction term between ARD and impaired MFR revealed no significant interaction effects between ARD and impaired MFR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In our retrospective cohort analysis, patients with ARD had significantly reduced PET MFR compared with age-, sex-, and comorbidity-matched patients without ARD. Reduced PET MFR and ARD diagnosis were both independent predictors of adverse outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.120.012208","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T09:00:21Z","timestamp":1631264421000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Association Between Impaired Myocardial Flow Reserve on\n            <sup>82<\/sup>\n            Rubidium Positron Emission Tomography Imaging and Adverse Events in Patients With Autoimmune Rheumatic Disease"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2561-4282","authenticated-orcid":true,"given":"Attila","family":"Feher","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine (A.F., E.K.O., Y.-H.L., E.J.M., A.J.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabil E.","family":"Boutagy","sequence":"additional","affiliation":[{"name":"Vascular Biology and Therapeutics Program (N.E.B.)"},{"name":"Department of Pharmacology (N.E.B.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-0720","authenticated-orcid":true,"given":"Evangelos K.","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine (A.F., E.K.O., Y.-H.L., E.J.M., A.J.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hwa","family":"Liu","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine (A.F., E.K.O., Y.-H.L., E.J.M., A.J.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Miller","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine (A.F., E.K.O., Y.-H.L., E.J.M., A.J.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Sinusas","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine (A.F., E.K.O., Y.-H.L., E.J.M., A.J.S.)"},{"name":"Department of Radiology and Biomedical Imaging (A.J.S.)"},{"name":"Department of Biomedical Engineering, Yale University, New Haven, CT (A.J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8652-9890","authenticated-orcid":true,"given":"Monique","family":"Hinchcliff","sequence":"additional","affiliation":[{"name":"Section of Rheumatology, Allergy &amp; Immunology, Department of Internal Medicine (M.H.)"},{"name":"Yale School of Medicine, New Haven, CT (M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","first-page":"445","article-title":"Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in Northern Sweden.","volume":"24","author":"Wallberg-Jonsson S","year":"1997","unstructured":"Wallberg-Jonsson, S, Ohman, ML, Dahlqvist, SR. Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in Northern Sweden. J Rheumatol. 1997;24:445\u2013451.","journal-title":"J Rheumatol"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009122"},{"key":"e_1_3_5_4_2","first-page":"71","article-title":"Risk of cardiovascular involvement in patients with primary Sj\u00f6gren\u2019s Syndrome: a large-scale cross-sectional cohort study.","volume":"44","author":"Cai X","year":"2019","unstructured":"Cai, X, Luo, J, Wei, T, Qin, W, Wang, X, Li, X. Risk of cardiovascular involvement in patients with primary Sj\u00f6gren\u2019s Syndrome: a large-scale cross-sectional cohort study. 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