Heart failure & cardiomyopathies
Coronary Microvascular Dysfunction in Patients With Heart Failure: Characterization of Patterns in HF with Reduced Ejection Fraction (HFrEF) Versus HFpEF
Authors' conclusion
Continuous intracoronary thermodilution allows the definition and characterization of patterns with distinct CMD in patients with HF and could identify patients with HFrEF with a higher rate of left ventricular reverse remodeling at follow-up.
Study context
- Population
- Consecutive patients with de novo heart failure (HF) and nonobstructive CAD
- Participants
- 56 patients
- Exposure
- HFrEF vs HFpEF
- HF with preserved ejection fractionn = 21reference
- HFrEFn = 35
- Outcome
- CMD (coronary flow reserve <2.5, by continuous intracoronary thermodilution)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
- Coronary microvascular dysfunction (CMD) prevalence, overall study population
- 52%
- HFrEF: CMD characterized by lower absolute microvascular resistance and higher absolute coronary flow at rest (functional CMD)
- P=0.002
- HFpEF: CMD mainly due to higher absolute microvascular resistance and lower absolute coronary flow during hyperemia (structural CMD)
- P≤0.030
Observational data: associations, not effects.
Further findings
LV and LAD-related myocardial mass
- Higher in HFrEF vs HFpEF
- P < 0.010
LV reverse remodeling (HFrEF) · follow-up
- CMD was an independent predictor of a lower rate of LV reverse remodeling
Original publication
Coronary Microvascular Dysfunction in Patients With Heart Failure: Characterization of Patterns in HFrEF Versus HFpEF. Circ Heart Fail. Published 18 December 2023. doi:10.
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