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The myocardial flow reserve in patients with heart failure with preserved ejection fraction

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Abstract

To evaluate the myocardial flow reserve (MFR) and myocardial blood flow (MBF) parameters in patients with heart failure with preserved ejection fraction (HFpEF) and to assess their relationship with the severity of HF and the levels of soluble ST2 (sST2). A total of 59 consecutive patients (median age of 65.0 (58.0; 69.0) years) with non-obstructive coronary artery disease (CAD) and preserved EF were enrolled. Serum levels biomarkers were measured by enzyme immunoassay. MBF and MFR parameters were evaluated by dynamic CZT-SPECT. All patients were divided into two groups: group 1 comprised patients (n = 41) with HFpEF, and group 2 comprised those (n = 18) without HFpEF. In group 1 global MFR (gMFR) values were lower by 27.8% (p = 0.003) than in group 2. The values of gMFR correlated with NT-proBNP (r = − 0.290) and sST2 (r = −0.331) levels. Based on ROC-analysis, gMFR ≤ 2.27 (AUC = 0.746; p < 0.001) were associated with the presence of HFpEF. In patients with HFpEF (n = 41) the values of gMFR were related to NYHA classes (p < 0.001) and the parameters of diastolic dysfunction (p < 0.001). The values of gMFR ≤ 2.27 may be used for the evaluation of microvascular changes in patients with HFpEF and non-obstructive CAD.

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Abbreviations

CAD:

Coronary artery disease

CFR:

Coronary flow reserve

CMD:

Coronary microvascular dysfunction

CMRI:

Cardiac magnetic resonance imaging

HFpEF:

Heart failure with preserved ejection fraction

MBF:

Myocardial blood flow

MFR:

Myocardial flow reserve

NT-proBNP:

N-terminal pro-B-type natriuretic peptide

PET:

Positron emission tomography

sST2:

Soluble suppression of tumorigenicity 2

TTDE:

Transthoracic Doppler echocardiography

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Funding

Grant of the President of the Russian Federation MK-4257.2022.3 and Fundamental Scientific Research No. 122020300044–8.

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Authors and Affiliations

  1. Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC), Russian Academy of Sciences (RAS), 111a, Kievskaya Str., Tomsk, 634012, Russian Federation

    Andrew V. Mochula, Kristina V. Kopeva, Alina N. Maltseva, Elena V. Grakova, Marina Gulya, Andrey V. Smorgon, Anna Gusakova & Konstantin V. Zavadovsky

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  1. Andrew V. Mochula
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  3. Alina N. Maltseva
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Mochula, A.V., Kopeva, K.V., Maltseva, A.N. et al. The myocardial flow reserve in patients with heart failure with preserved ejection fraction. Heart Vessels 38, 348–360 (2023). https://doi.org/10.1007/s00380-022-02161-5

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