冠状动脉血流储备、炎症与心肌应变：CIRT-CFR试验

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

作者信息

Taqueti Viviany R, Shah Amil M, Everett Brendan M, Pradhan Aruna D, Piazza Gregory, Bibbo Courtney, Hainer Jon, Morgan Victoria, Carolina do A H de Souza Ana, Skali Hicham, Blankstein Ron, Dorbala Sharmila, Goldhaber Samuel Z, Le May Michel R, Chow Benjamin J W, deKemp Robert A, Hage Fadi G, Beanlands Rob S, Libby Peter, Glynn Robert J, Solomon Scott D, Ridker Paul M, Di Carli Marcelo F

机构信息

Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

JACC Basic Transl Sci. 2022 Dec 21;8(2):141-151. doi: 10.1016/j.jacbts.2022.08.009. eCollection 2023 Feb.

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).

炎症是心血管疾病预后的关键决定因素，但其在心力衰竭中的作用尚不确定。在参与CIRT（心血管炎症减少试验）前瞻性多中心辅助研究CIRT-CFR（用于评估心血管炎症的冠状动脉血流储备）的心脏代谢疾病患者中，尽管脂质、血糖和血流动力学指标控制良好，但冠状动脉血流储备受损与炎症增加和心肌应变独立相关。炎症改变了CFR与心肌应变之间的关系，破坏了心脏血流与功能之间的关联。未来需要开展研究，以调查早期由炎症介导的CFR降低（反映微血管缺血）是否会导致心脏代谢疾病患者发生心力衰竭。（心血管炎症减少试验 [CIRT]；NCT01594333；用于评估心血管炎症的冠状动脉血流储备 [CIRT-CFR]；NCT02786134）