Coronary Flow Reserve, Inflammation, and Myocardial Strain

Figures

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  Figure 1. CFR Was Significantly Associated With Markers of Systemic Inflammation and Myocardial Strain Subjects with a CFR of <2 demonstrated increased levels of (A) serologic markers of inflammation (IL-6) and (B) myocardial strain (NT-proBNP), which were paralleled by (C) worse echocardiographic GLS. Loess regression fit with automated smoothing, and 95% confidence limits are shown; r reflects the strength of linear associations between variables. CFR = coronary flow reserve; GLS = global longitudinal strain; IL = interleukin; LV = left ventricular; NT-proBNP = N-terminal pro–B-type natriuretic peptide.

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  Figure 2. Inflammation Was Associated With Uncoupling of the Relationship Between CFR and GLS Study subjects with the highest median values of (A) IL-6 or (B) IL-1β demonstrated the weakest relationship between CFR and GLS (adjusted P for interaction = 0.006 and 0.012 for IL-6 and IL-1β, respectively). hi = high; lo = low; other abbreviations as in Figure 1.

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  Figure 3. Relationship Between Markers of Heart Failure and Inflammation Stratified by CFR There was a significant association between markers of heart failure (NT-proBNP) and inflammation (IL-6) for (A) those with IL-6 of >2 ng/L, which was most evident in (B) subjects with impaired CFR of <2 (adjusted P for interaction = 0.017). Abbreviations as in Figure 1.

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  Figure 4. Inflammation Is a Key Determinant of Cardiovascular Outcomes, Which May Include Heart Failure In patients with cardiometabolic disease enrolled in CIRT-CFR (Coronary Flow Reserve to Assess Cardiovascular Inflammation): 1) impaired CFR was independently associated with markers of increased inflammation and myocardial strain despite well-controlled glycemic, lipid, and hemodynamic profiles, 2) inflammation was associated with disruption of the relationship between cardiac blood flow and function, and 3) individuals with impaired CFR demonstrated the strongest association between markers of heart failure and inflammation. hsCRP = high-sensitivity C-reactive protein; hsTNT = high-sensitivity troponin T; MACE = major adverse cardiac event; NLRP3 = NOD-like receptor protein 3; other abbreviations as in Figure 1.