Peña-Cabral MA

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Publications (2)14.74 Total impact

  • Source
    Article: Endothelial dysfunction and myocardial ischemia evaluated with 13N-ammonia PET in patients with systemic lupus erythematosus or primary antiphospholipid syndrome
    Alexanderson E, Telich-Tarriba JE, Iñarra F, Marroquin L, Jacome R, Jimenez-Santos M, Romero E, Peña-Cabral MA, Meave A, Posadas-Romero C
    [show abstract] [hide abstract]
    ABSTRACT: Introduction: A significant correlation between autoimmune diseases and accelerated coronary atherosclerosis has been found, increasing the risk of developing cardiovascular disease. Objectives: The aim of this study was to evaluate the presence of endothelial dysfunction and myocardial ischemia in asymptomatic patients with Sistemic Lupus Erythematosus (SLE) or Primary Antiphospholipid Syndrome (PAPS) without other Coronary Artery Disease (CAD) risk factors by 13N-ammonia PET. Methods: We studied 52 patients, 16 with inactive SLE, 18 with PAPS and 18 healthy volunteers. All underwent a 3 phase (rest, Cold Pressor Test and pharmacological stress) 13N-Ammonia PET on a 64 slice PET/CT scanner. Endothelial dysfunction was evaluated with Myocardial Blood Flow Quantification (MBF, ml/g/min) from the Dynamic images, the Endothelium-dependent Vasodilation Index (ENDEVI, CPT MBF/rest MBF, normal �1,5), %�MBF (normal �50%) and Coronary Flow Reserve (CFR, stress MBF/rest MBF, normal �2,5) were calculated as Endothelial function parameters. Myocardial ischemia was evaluated by two experts in the field. Results: The mean age of the patients was 36,2 � 9.5 years whilst the mean age of the control group was 34 � 7 years. All of the patients were asymptomatic. Compared with the control group, the patients with SLE/PAPS had a significantly lower ENDEVI (1.18 � 0.55 vs 1.55 � 0.37, p � 0.015), %�MBF (18.5 � 43 vs 55 � 37, p � 0.015) and a non-significant lower MFR (2.58 � 0.81 vs 3.27 � 0.72, p � 0.26). We found ischemia in14/34 patients (41%) in the SLE/PAPS group, all the healthy volunteers studied showed normal myocardial perfusion images. Conclusion: Like other auto-immune diseases, and mostly due to the chronic inflammatory process, patients with SLE or PAPS have Endothelial Dysfunction. Even though these patients were asymptomatic and had low risk of CV disease, 41% of them had Myocardial ischemia without overt coronary atherosclerosis. Myocardial Blood Flow quantification with PET allows us to detect patients at risk of developing CAD from the earliest stages of the disease and intervene before the development of overt Myocardial ischemia.
    Circulation. 05/2012; 125(19):e52-e53.
  • Source
    Article: Endothelial dysfunction and myocardial ischemia evaluated with 13N-ammonia PET in patients with systemic lupus erythematosus or primary antiphospholipid syndrome
    Alexanderson E, Telich-Tarriba JE, Iñarra F, Marroquin L, Jacome R, Jimenez-Santos M, Romero E, Peña-Cabral MA, Meave A, Posadas-Romero C
    [show abstract] [hide abstract]
    ABSTRACT: Introduction: A significant correlation between autoimmune diseases and accelerated coronary atherosclerosis has been found, increasing the risk of developing cardiovascular disease. Objectives: The aim of this study was to evaluate the presence of endothelial dysfunction and myocardial ischemia in asymptomatic patients with Sistemic Lupus Erythematosus (SLE) or Primary Antiphospholipid Syndrome (PAPS) without other Coronary Artery Disease (CAD) risk factors by 13N-ammonia PET. Methods: We studied 52 patients, 16 with inactive SLE, 18 with PAPS and 18 healthy volunteers. All underwent a 3 phase (rest, Cold Pressor Test and pharmacological stress) 13N-Ammonia PET on a 64 slice PET/CT scanner. Endothelial dysfunction was evaluated with Myocardial Blood Flow Quantification (MBF, ml/g/min) from the Dynamic images, the Endothelium-dependent Vasodilation Index (ENDEVI, CPT MBF/rest MBF, normal > 1,5), %∆MBF (normal > 50%) and Coronary Flow Reserve (CFR, stress MBF/rest MBF, normal > 2,5) were calculated as Endothelial function parameters. Myocardial ischemia was evaluated by two experts in the field. Results: The mean age of the patients was 36,2 ± 9.5 years whilst the mean age of the control group was 34 ± 7 years. All of the patients were asymptomatic. Compared with the control group, the patients with SLE/PAPS had a significantly lower ENDEVI (1.18 ± 0.55 vs 1.55 ± 0.37, p = 0.015), %∆MBF (18.5 ± 43 vs 55 ± 37, p = 0.015) and a non-significant lower MFR (2.58 ± 0.81 vs 3.27 ± 0.72, p = 0.26). We found ischemia in14/34 patients (41%) in the SLE/PAPS group, all the healthy volunteers studied showed normal myocardial perfusion images. Conclusion: Like other auto-immune diseases, and mostly due to the chronic inflammatory process, patients with SLE or PAPS have Endothelial Dysfunction. Even though these patients were asymptomatic and had low risk of CV disease, 41% of them had Myocardial ischemia without overt coronary atherosclerosis. Myocardial Blood Flow quantification with PET allows us to detect patients at risk of developing CAD from the earliest stages of the disease and intervene before the development of overt Myocardial ischemia.
    Circulation 05/2012; 125(59):e52-e53. · 14.74 Impact Factor

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