Myocardial first pass perfusion assessed by cardiac magnetic resonance and coronary microvascular dysfunction in women with angina and no obstructive coronary artery disease

Mygind, Naja Dam; Michelsen, Marie Mide; Qayyum, Abbas Ali; Frestad, Daria; Christensen, Thomas Emil; Ghotbi, Adam Ali; Hasbak, Phillip; Kjær, Andreas; Vejlstrup, Niels; Gustafsson, Ida; Hansen, Peter Riis; Hansen, Henrik Steen; Prescott, Eva; Kastrup, Jens

doi:10.1080/00365513.2019.1587670

Cited by 22 publications

(13 citation statements)

References 42 publications

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“…It could well be that the relation between low testosterone and secondary outcome is mediated by changes in vascular hemostasis and thrombosis. Testosterone is known to affect platelets ( 36 ), but an effect on thrombosis has not been found ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Plasma Testosterone Levels and Atherosclerotic Plaque Gene Expression in Men With Advanced Atherosclerosis

Groepenhoff

Benavente

Boltjes

et al. 2021

Front. Cardiovasc. Med.

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Aims: Low plasma testosterone levels have been shown to predict worse outcome in men with severe atherosclerotic disease. We hypothesized that a low plasma testosterone level affects disease risk through changes in gene expression in atherosclerotic plaques. Therefore, we studied plasma testosterone levels in relation to gene expression levels in atherosclerotic plaque tissue of men with advanced atherosclerotic disease.Methods: Plasma testosterone levels were measured in 203 men undergoing carotid endarterectomy. The corresponding atherosclerotic plaque tissue was used for RNA sequencing. First, we assessed how often the androgen receptor gene was expressed in the plaque. Second, correlations between plasma testosterone levels and pre-selected testosterone-sensitive genes were assessed. Finally, differences within the RNA expression profile of the plaque as a whole, characterized into gene regulatory networks and at individual gene level were assessed in relation to testosterone levels.Results: Testosterone plasma levels were low with a median of 11.6 nmol/L (IQR: 8.6–13.8). RNA-seq of the plaque resulted in reliable expression data for 18,850 genes to be analyzed. Within the RNA seq data, the androgen-receptor gene was expressed in 189 out of 203 (93%) atherosclerotic plaques of men undergoing carotid endarterectomy. The androgen receptor gene expression was not associated with testosterone plasma levels. There were no significant differences in gene expression of atherosclerotic plaques between different endogenous testosterone levels. This remained true for known testosterone-sensitive genes, the complete transcriptomic profile, male-specific gene co-expression modules as well as for individual genes.Conclusion: In men with severe atherosclerotic disease the androgen receptor is highly expressed in plaque tissue. However, plasma testosterone levels were neither associated with pre-selected testosterone sensitive genes, gene expression profiles nor gene regulatory networks in late-stage atherosclerotic plaques. The effect of testosterone on gene expression of the late-stage atherosclerotic plaque appears limited, suggesting that alternate mechanisms explain its effect on clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Plasma Testosterone Levels and Atherosclerotic Plaque Gene Expression in Men With Advanced Atherosclerosis

Groepenhoff

Benavente

Boltjes

et al. 2021

Front. Cardiovasc. Med.

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“…Several recent studies are focusing on the myocardial perfusion reserve index obtained by first-pass perfusion CMR imaging with vasodilator stress that can detect coronary microvascular disease in a manner quite similar to invasive coronary reactivity testing [ 54 , 55 ].…”

Section: Cardiovascular Disease In Women: Sex-associated Differencesmentioning

confidence: 99%

Gender Medicine in Clinical Radiology Practice

Giacobbe

Granata

Trovato

et al. 2023

JPM

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Gender Medicine is rapidly emerging as a branch of medicine that studies how many diseases common to men and women differ in terms of prevention, clinical manifestations, diagnostic-therapeutic approach, prognosis, and psychological and social impact. Nowadays, the presentation and identification of many pathological conditions pose unique diagnostic challenges. However, women have always been paradoxically underestimated in epidemiological studies, drug trials, as well as clinical trials, so many clinical conditions affecting the female population are often underestimated and/or delayed and may result in inadequate clinical management. Knowing and valuing these differences in healthcare, thus taking into account individual variability, will make it possible to ensure that each individual receives the best care through the personalization of therapies, the guarantee of diagnostic-therapeutic pathways declined according to gender, as well as through the promotion of gender-specific prevention initiatives. This article aims to assess potential gender differences in clinical-radiological practice extracted from the literature and their impact on health and healthcare. Indeed, in this context, radiomics and radiogenomics are rapidly emerging as new frontiers of imaging in precision medicine. The development of clinical practice support tools supported by artificial intelligence allows through quantitative analysis to characterize tissues noninvasively with the ultimate goal of extracting directly from images indications of disease aggressiveness, prognosis, and therapeutic response. The integration of quantitative data with gene expression and patient clinical data, with the help of structured reporting as well, will in the near future give rise to decision support models for clinical practice that will hopefully improve diagnostic accuracy and prognostic power as well as ensure a more advanced level of precision medicine.

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“…In patients with stable CAD, Engblom H et al showed a good agreement ( r = 0.92) between CMR and PET in the assessment of global MBF [ 32 ]. In a cohort of women with angina and no obstructive CAD, Mygind et al showed a moderate but significant correlation between CMR and PET in MVD identification ( r = 0.46, p < 0.001) [ 33 ]. The results of CMR also correlated well with data from invasive measurements, independently from biomarkers of atherosclerosis [ 34 ].…”

Section: Cardiovascular Mrimentioning

confidence: 99%

Coronary Microvascular Dysfunction: PET, CMR and CT Assessment

Tonet

Pompei

Faragasso³

et al. 2021

JCM

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Microvascular dysfunction is responsible for chest pain in various kinds of patients, including those with obstructive coronary artery disease and persistent symptoms despite revascularization, or those with myocardial disease without coronary stenosis. Its diagnosis can be performed with an advanced imaging technique such as positron emission tomography, which represents the gold standard for diagnosing microvascular abnormalities. In recent years, cardiovascular magnetic resonance and cardiac computed tomography have demonstrated to be emerging modalities for microcirculation assessment. The identification of microvascular disease represents a fundamental step in the characterization of patients with chest pain and no epicardial coronary disease: its identification is important to manage medical strategies and improve prognosis. The present overview summarizes the main techniques and current evidence of these advanced imaging strategies in assessing microvascular dysfunction and, if present, their relationship with invasive evaluation.

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Myocardial first pass perfusion assessed by cardiac magnetic resonance and coronary microvascular dysfunction in women with angina and no obstructive coronary artery disease

Cited by 22 publications

References 42 publications

Plasma Testosterone Levels and Atherosclerotic Plaque Gene Expression in Men With Advanced Atherosclerosis

Plasma Testosterone Levels and Atherosclerotic Plaque Gene Expression in Men With Advanced Atherosclerosis

Gender Medicine in Clinical Radiology Practice

Coronary Microvascular Dysfunction: PET, CMR and CT Assessment

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