Abstract
Background: The Heart Failure with Preserved Ejection Fraction (HFpEF) is defined as the preserved left ventricular ejection fraction (LVEF) with the signs of heart failure, elevated natriuretic peptides, and either the evidence of the structural heart disease or diastolic dysfunction. The importance of this form of heart failure was increased after studies where the mortality rates and readmission to the hospital were founded similar as in patients with HF and reduced EF (HFrEF). Coronary microvascular ischemia, cardiomyocyte injury and stiffness could be important factors in the pathophysiology of HFpEF. Methods: The goal of this work is to analyse the relationship of HFpEF and coronary microcirculation in previous studies.
Results: The useful diagnostic marker of coronary microcirculation in HFpEF may be the parameters measured by transthoracic echocardiography (TTE), the coronary flow reserve (CFR), as well as fractional flow reserve (FFR) and quantitative myocardial contrast echocardiography (MCE). Cardiac magnetic resonance (CMR) imaging represents the diagnostic gold standard in HFpEF. Coronary microvascular dysfunction in the absence of obstructive coronary artery disease (CAD) is poorly understood and may be more prevalent amongst women than men. Troponin level may be important in risk stratification of HEpEF patients.
Conclusion: There are no precise answers with respect to the pathophysiological mechanism, nor are there any precise practical clinical assessment of and diagnostic method for coronary microvascular dysfunction and diastolic dysfunction. In accordance with that, there is no well-established treatment for HFpEF.
Keywords: Heart failure with preserved ejection fraction, Coronary microvascular dysfunction, Diastolic dysfunction, Troponin level, Coronary flow reserve, Cardiac magnetic resonance.
Current Pharmaceutical Design
Title:Coronary Microcirculation in Heart Failure with Preserved Systolic Function
Volume: 24 Issue: 25
Author(s): Zorana Vasiljevic*, Gordana Krljanac, Marija Zdravkovic, Ratko Lasica, Danijela Trifunovic and Milika Asanin
Affiliation:
- University of Belgrade, Faculty of Medicine, Belgrade,Serbia
Keywords: Heart failure with preserved ejection fraction, Coronary microvascular dysfunction, Diastolic dysfunction, Troponin level, Coronary flow reserve, Cardiac magnetic resonance.
Abstract: Background: The Heart Failure with Preserved Ejection Fraction (HFpEF) is defined as the preserved left ventricular ejection fraction (LVEF) with the signs of heart failure, elevated natriuretic peptides, and either the evidence of the structural heart disease or diastolic dysfunction. The importance of this form of heart failure was increased after studies where the mortality rates and readmission to the hospital were founded similar as in patients with HF and reduced EF (HFrEF). Coronary microvascular ischemia, cardiomyocyte injury and stiffness could be important factors in the pathophysiology of HFpEF. Methods: The goal of this work is to analyse the relationship of HFpEF and coronary microcirculation in previous studies.
Results: The useful diagnostic marker of coronary microcirculation in HFpEF may be the parameters measured by transthoracic echocardiography (TTE), the coronary flow reserve (CFR), as well as fractional flow reserve (FFR) and quantitative myocardial contrast echocardiography (MCE). Cardiac magnetic resonance (CMR) imaging represents the diagnostic gold standard in HFpEF. Coronary microvascular dysfunction in the absence of obstructive coronary artery disease (CAD) is poorly understood and may be more prevalent amongst women than men. Troponin level may be important in risk stratification of HEpEF patients.
Conclusion: There are no precise answers with respect to the pathophysiological mechanism, nor are there any precise practical clinical assessment of and diagnostic method for coronary microvascular dysfunction and diastolic dysfunction. In accordance with that, there is no well-established treatment for HFpEF.
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Cite this article as:
Vasiljevic Zorana *, Krljanac Gordana , Zdravkovic Marija , Lasica Ratko , Trifunovic Danijela and Asanin Milika, Coronary Microcirculation in Heart Failure with Preserved Systolic Function, Current Pharmaceutical Design 2018; 24 (25) . https://dx.doi.org/10.2174/1381612824666180711124131
DOI https://dx.doi.org/10.2174/1381612824666180711124131 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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