Myocardial Scar Is Prevalent and Associated With Subclinical Myocardial Dysfunction in Women With Suspected Ischemia But No Obstructive Coronary Artery Disease From the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction Study

• Type of Material: Article
• Authors: Janet Wei, Cedars Sinai Heart Institute; May Bakir, Cedars Sinai Heart Institute; Navid Darounian, Cedars Sinai Heart Institute; Quanlin Li, Cedars Sinai Medical Center; Sofy Landes, Cedars Sinai Heart Institute; Puja Mehta, Emory University; Chrisandra L. Shufelt, Cedars Sinai Heart Institute; Eileen M. Handberg, University of Florida; Sheryl F. Kelsey, University of Pittsburgh; George Sopko, National Heart, Lung, and Blood Institute; Carl J. Pepine, University of Florida; John W. Petersen, University of Florida; Daniel S. Berman, Cedars Sinai Heart Institute; Louise E. J. Thomson, Cedars Sinai Heart Institute; C. Noel Bairey Merz, Cedars Sinai Heart Institute
• Language: English
• Date: 2018-02-20
• Publisher: American Heart Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 American Heart Association, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1161/CIRCULATIONAHA.117.031999
• Title of Journal or Parent Work: Circulation
• ISSN: 0009-7322
• Volume: 137
• Issue: 8
• Start Page: 874
• End Page: 876
• Grant/Funding Information: Dr. Pepine was also supported by National Institute of Health grants HL33610, HL56921; UM1 HL087366; the Gatorade Trust through funds distributed by the University of Florida, Department of Medicine; NIH National Center for Advancing Translational Sciences (NCATS)—University of Florida Clinical and Translational Science UL1TR001427; and PCORnet-OneFlorida Clinical Research Consortium CDRN-1501-26692.; This work was supported by contracts from the National Heart, Lung and Blood Institutes nos. N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164, grants U0164829, U01 HL649141, U01 HL649241, K23HL105787, T32HL69751, R01 HL090957, 1R03AG032631 from the National Institute on Aging, General Clinical Research Center (GCRC) grant MO1-RR00425 from the National Center for Research Resources, the National Center for Advancing Translational Sciences Grant UL1TR000124 and UL1TR000064, and grants from the Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ, The Women’s Guild of Cedars-Sinai Medical Center, Los Angeles, CA, The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA, and QMED, Inc., Laurence Harbor, NJ, the Edythe L. Broad and the Constance Austin Women’s Heart Research Fellowships, Cedars-Sinai Medical Center, Los Angeles, California, the Barbra Streisand Women’s Cardiovascular Research and Education Program, Cedars-Sinai Medical Center, Los Angeles, The Society for Women’s Health Research (SWHR), Washington, D.C., The Linda Joy Pollin Women’s Heart Health Program, the Erika J. Glazer Women’s Heart Research Initiative, and the Adelson Family Foundation, Cedars-Sinai Medical Center, Los Angeles, California.
• Keywords: Cardiac & Cardiovascular Systems; chronic ischemic heart disease; women; Science & Technology; Cardiovascular System & Cardiology; magnetic resonance imaging; Life Sciences & Biomedicine; Peripheral Vascular Disease
• Research Categories: Biology, Biostatistics; Health Sciences, Medicine and Surgery

Abstract

Women with suspected ischemia and no obstructive coronary artery disease (INOCA) have a high prevalence of coronary microvascular dysfunction (CMD)1 and an elevated major adverse cardiac event (MACE) rate, including nonfatal myocardial infarction (MI)2. Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) imaging accurately visualizes and characterizes myocardial scar which predicts MACE3. The prevalence, incidence and scar pattern in women with INOCA is not well characterized. We evaluated LGE in women with suspected INOCA in the Women’s Ischemia Syndrome Evaluation – Coronary Vascular Dysfunction (WISE-CVD) study. (Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00832702.)