Chronic inflammation and coronary microvascular dysfunction in patients without risk factors for coronary artery disease.

Aims: To demonstrate that exposure to chronic inflammation results in coronary microvascular dysfunction (CMD).

Methods And Results: Using positron emission tomography, resting and hyperaemic (adenosine, 140 microg/kg/min) myocardial blood flow (MBF) was measured in 25 patients with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). Coronary flow reserve (CFR) was calculated as adenosine/resting MBF. Patients had normal or minimally diseased (i.e.
Conclusion: A reduced CFR in the absence of significant coronary disease is suggestive of CMD. We speculate that this is the consequence of prolonged systemic inflammation, which may precede and contribute to premature coronary artery disease in these patients.