TY - JOUR T1 - Impaired Myocardial Flow Reserve on <sup>82</sup>Rubidium Positron Emission Tomography/Computed Tomography in Patients With Systemic Sclerosis JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.210040 SP - jrheum.210040 AU - Attila Feher AU - Nabil E. Boutagy AU - Evangelos K. Oikonomou AU - Stephanie Thorn AU - Yi-Hwa Liu AU - Edward J. Miller AU - Albert J. Sinusas AU - Monique Hinchcliff Y1 - 2021/07/15 UR - http://www.jrheum.org/content/early/2021/08/26/jrheum.210040.abstract N2 - Objective To investigate the association between Raynaud phenomenon (RP) and coronary microvascular dysfunction, we measured myocardial flow reserve (MFR) using positron emission tomography/computed tomography (PET/CT) in patients with primary and secondary RP and controls. Methods Patients with RP, patient controls, and healthy participants who underwent dynamic rest-stress 82-rubidium PET/CT were studied. Differences in heart rate–blood pressure product-corrected MFR and clinical predictors of reduced MFR (&lt; 2.0) were determined. Results Forty-nine patients with RP (80% female; aged 65 ± 11 yrs; 11 with primary RP, 18 with systemic sclerosis [SSc], and 20 with other autoimmune rheumatic diseases [AIRDs] including 6 with systemic lupus erythematosus, 6 with rheumatoid arthritis, 4 with overlap syndrome, 2 with Sjögren syndrome, and 2 with inflammatory arthritis), 49 matched patients without RP or AIRD (78% female; 64 ± 13 yrs), and 14 healthy participants (50% female; 35 ± 5 yrs) were studied. Patients with primary RP, matched patient controls, and healthy participants had comparable MFR. Patients with SSc-RP had significantly reduced MFR (1.62 ± 0.32) compared to matched patient controls (P = 0.03, 2.06 ± 0.61) and to healthy participants (P = 0.01, 2.22 ± 0.44). In multivariable logistic regression, SSc was an independent predictor of reduced MFR. We identified a correlation between time since AIRD diagnosis and MFR (r = –0.30, 95% CI –0.63 to –0.02, P = 0.04). Conclusion Our findings suggest that only secondary, not primary, RP is associated with reduced MFR, and that patients with SSc-RP have reduced MFR compared to those with primary RP and patients with other AIRDs. Larger prospective studies are warranted to fully elucidate the prognostic value of MFR in patients with secondary RP. ER -