Coronary Flow Reserve, Inflammation, and Myocardial Strain The CIRT-CFR Trial

Inflammation is a key determinant of cardiovascular outcomes, but its role in heart failure is uncertain. In patients with cardiometabolic disease enrolled in the prospective, multicenter ancillary study of CIRT (Cardiovascular Inflammation Reduction Trial), CIRT-CFR (Coronary Flow Reserve to Assess Cardiovascular Inflammation), impaired coronary flow reserve was independently associated with increased inflammation and myocardial strain despite well-controlled lipid, glycemic, and hemodynamic profiles. Inflammation modified the relationship between CFR and myocardial strain, disrupting the association between cardiac blood flow and function. Future studies are needed to investigate whether an early inflammation-mediated reduction in CFR capturing microvascular ischemia may lead to heart failure in patients with cardiometabolic disease. (Cardiovascular Inflammation Reduction Trial [CIRT]; NCT01594333; Coronary Flow Reserve to Assess Cardiovascular Inflammation [CIRT-CFR]; NCT02786134) (J Am Coll Cardiol Basic Trans Science 2023;8:141-151) Crown Copyright & COPY; 2023 Published by Elsevier on behalf of American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

Inflammation plays a role in cardiovascular outcomes, but its role in heart failure is uncertain. Impaired coronary flow reserve is associated with increased inflammation and myocardial strain in patients with cardiometabolic disease, independently of lipid, glycemic, and hemodynamic profiles. Future studies are needed to investigate whether early inflammation-mediated reduction in coronary flow reserve may lead to heart failure in these patients.