PMID- 31340567 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200930 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 8 IP - 7 DP - 2019 Jul 23 TI - Silent Myocardial Perfusion Abnormalities Detected by Stress Cardiovascular Magnetic Resonance in Antiphospholipid Syndrome: A Case-Control Study. LID - 10.3390/jcm8071084 [doi] LID - 1084 AB - Objective: To examine the prevalence of silent myocardial ischemia and fibrosis in antiphospholipid syndrome (APS), using stress cardiovascular magnetic resonance (CMR). Methods: Forty-four consecutive APS patients without prior cardiac disease (22 primary APS, 22 systemic lupus erythematosus (SLE)/APS, mean age 44 (12.9) years, 64% women) and 44 age/gender-matched controls were evaluated using CMR at 1.5 T. Steady-state free precession imaging for function assessment and adenosine stress-CMR for perfusion-fibrosis evaluation were employed. The myocardial perfusion reserve index (MPRI), and myocardial fibrosis expressed as late gadolinium enhancement (LGE), were evaluated. Coronary angiography was indicated in patients with LGE. Associations with APS characteristics, classic cardiovascular disease (CVD) risk factors, high-sensitivity CRP (hs-CRP) and high-sensitivity Troponin (hs-TnT) levels were tested. All patients were followed up for 12 months. Results: Median MPRI was significantly lower in APS patients versus controls [1.5 (0.9-1.9) vs. 2.7 (2.2-3.2), p < 0.001], independently of any LGE presence. LGE was detected in 16 (36.3%) patients versus none of controls (p < 0.001); 12/16 were subsequently examined with coronary angiography and only two of them had coronary artery lesions. In multivariable analysis, none of the APS-related and classic CVD risk factors, or hs-CRP and hs-TnT covariates, were significant predictors of abnormal MPRI or LGE. At the twelve month follow-up, three (6.8%) patients experienced coronary artery disease, notably those with the lowest MPRI values. Conclusions: Abnormal MPRI and LGE are common in asymptomatic APS patients, independently so of any APS-related and classic CVD risk factors, or coronary angiography findings in cases with LGE. Stress-CMR is a valuable tool to detect silent myocardial ischemia and fibrosis in APS. FAU - Mavrogeni, Sophie I AU - Mavrogeni SI AD - Onassis Cardiac Surgery Center, 17674 Athens, Greece. FAU - Markousis-Mavrogenis, George AU - Markousis-Mavrogenis G AD - Onassis Cardiac Surgery Center, 17674 Athens, Greece. FAU - Karapanagiotou, Olga AU - Karapanagiotou O AD - Onassis Cardiac Surgery Center, 17674 Athens, Greece. FAU - Toutouzas, Konstantinos AU - Toutouzas K AD - First Cardiology Department, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Argyriou, Panagiotis AU - Argyriou P AD - Radiology Department, Mediterraneo Hospital, 16675 Athens, Greece. FAU - Velitsista, Stella AU - Velitsista S AD - Radiology Department, Mediterraneo Hospital, 16675 Athens, Greece. FAU - Kanoupakis, George AU - Kanoupakis G AD - Radiology Department, Mediterraneo Hospital, 16675 Athens, Greece. FAU - Apostolou, Dimitrios AU - Apostolou D AD - Radiology Department, Mediterraneo Hospital, 16675 Athens, Greece. FAU - Hautemann, David AU - Hautemann D AD - Leiden University Medical Center, 2333 ZA Leiden, The Netherlands. FAU - Sfikakis, Petros P AU - Sfikakis PP AD - First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Tektonidou, Maria G AU - Tektonidou MG AD - First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. mtektonidou@gmail.com. LA - eng GR - 11123/Special Account for Research Grants of the National and Kapodistrian University of Athens Medical School, Greece/ PT - Journal Article DEP - 20190723 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC6678220 OTO - NOTNLM OT - antiphospholipid syndrome OT - autoimmune rheumatic diseases OT - cardiovascular disease OT - cardiovascular magnetic resonance OT - ischemic cardiac disease OT - late gadolinium enhancement OT - myocardial fibrosis OT - myocardial ischemia COIS- Authors declare no conflict of interest. EDAT- 2019/07/26 06:00 MHDA- 2019/07/26 06:01 PMCR- 2019/07/23 CRDT- 2019/07/26 06:00 PHST- 2019/06/19 00:00 [received] PHST- 2019/07/12 00:00 [revised] PHST- 2019/07/20 00:00 [accepted] PHST- 2019/07/26 06:00 [entrez] PHST- 2019/07/26 06:00 [pubmed] PHST- 2019/07/26 06:01 [medline] PHST- 2019/07/23 00:00 [pmc-release] AID - jcm8071084 [pii] AID - jcm-08-01084 [pii] AID - 10.3390/jcm8071084 [doi] PST - epublish SO - J Clin Med. 2019 Jul 23;8(7):1084. doi: 10.3390/jcm8071084.