Why the study?
Women with coronary microvascular dysfunction experience higher rates of adverse cardiovascular events including HFpEF, leading to the hypothesis that coronary microvascular dysfunction contributes to the progression of HFpEF.
This case report supports the hypothesis that coronary microvascular dysfunction may be a precursor to heart failure with preserved ejection fraction.
Hypothesis-generating for CMD driving HFpEF progression in women with INOCA; leaves open need for targeted trials.
BACKGROUND: In women with evidence of ischemia and no obstructive coronary artery disease the underlying mechanism is most often attributed to coronary microvascular dysfunction. Higher rates of adverse cardiovascular events, specifically heart failure with preserved ejection fraction, are present in women with coronary microvascular dysfunction, leading to the hypothesis that coronary microvascular dysfunction may contribute to the progression of heart failure with preserved ejection fraction. A 55-year-old, Caucasian woman with a past medical history of chest pain and shortness of breath was referred to our tertiary care center and diagnosed as having coronary microvascular dysfunction by invasive coronary reactivity testing. After 10 years of follow-up care for coronary microvascular dysfunction, she presented to an emergency room in acute heart failure and was diagnosed as having heart failure with preserved ejection fraction. DISCUSSION: The current case report provides a specific example in support of existing studies that demonstrate that coronary microvascular dysfunction may be a precursor of heart failure with preserved ejection fraction. Further research is needed to establish causality and management. TRIAL REGISTRATION: Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02582021 .
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Joung et al. (2019) studied this question.
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