{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T01:54:14Z","timestamp":1793930054164,"version":"4.8.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disorder associated with premature atherosclerosis and increased cardiovascular risk. Systemic inflammation is an emerging risk factor for coronary microvascular dysfunction (CMD). We aimed to test whether CMD, defined as abnormal myocardial flow reserve (MFR) by positron emission tomography\u2010computed tomography, would be independently associated with SLE after adjusting for nonobstructive atherosclerotic burden and common cardiovascular risk factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Consecutive patients with SLE who underwent symptom\u2010prompted stress cardiac positron emission tomography\u2010computed tomography were included (n=42). Obstructive coronary artery disease and systolic dysfunction were excluded. MFR was quantified by positron emission tomography\u2010computed tomography, and CMD was defined as MFR &lt;2. We frequency matched patients who did not have SLE and had symptom\u2010prompted positron emission tomography studies on age, sex, and key cardiovascular risk factors (n=69). The attenuation correction computed tomography scans were reviewed for qualitative assessment of coronary artery calcium. Patients with SLE had a more severe reduction in global MFR compared with controls and a higher prevalence of CMD, despite a similar degree of nonobstructive atherosclerotic burden (1.91\u00b10.5 versus 2.4\u00b10.7, respectively,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001; CMD, 57.1% versus 33.3%, respectively,\n              <jats:italic>P<\/jats:italic>\n              =0.017).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">We demonstrated that patients with SLE with cardiac symptoms without obstructive coronary artery disease have a high prevalence of coronary vasomotor abnormalities. In comparison with symptomatic matched controls, patients with SLE have a more severe reduction in MFR that is not accounted for by common cardiovascular factors or atherosclerotic burden.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018555","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T09:19:34Z","timestamp":1623835174000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Coronary Microvascular Dysfunction in Systemic Lupus Erythematosus"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0177-2091","authenticated-orcid":false,"given":"Brittany N.","family":"Weber","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Department of MedicineBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"},{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Stevens","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation, and Immunity Brigham and Women\u2019s Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Barrett","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camden","family":"Bay","sequence":"additional","affiliation":[{"name":"Department of Radiology Brigham and Women\u2019s HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine","family":"Sinnette","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation, and Immunity Brigham and Women\u2019s Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6647-639X","authenticated-orcid":false,"given":"Jenifer M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of MedicineBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"},{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0598-6502","authenticated-orcid":false,"given":"Sanjay","family":"Divakaran","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of MedicineBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"},{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Bibbo","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0572-912X","authenticated-orcid":false,"given":"Jon","family":"Hainer","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1462-1185","authenticated-orcid":false,"given":"Sharmila","family":"Dorbala","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Blankstein","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of MedicineBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"},{"name":"Cardiovascular Imaging Program Departments of Medicine and RadiologyBrigham and Women\u2019s HospitalHarvard Medical SchoolBoston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4797-3200","authenticated-orcid":false,"given":"Katherine","family":"Liao","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation, and Immunity Brigham and Women\u2019s Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Massarotti","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Inflammation, and Immunity Brigham and 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