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Cardiac morphology and function were analysed with Doppler echocardiography and coronary flow velocity reserve (CFVR) in response to adenosine was measured in the left anterior descendent artery to detect coronary microvascular dysfunction (CMD). All study subjects had a left ventricular (LV) ejection fraction &amp;gt; 50%. Patients with CKD showed statistically significant increases in left atrial volume index and transmitral and pulmonary vein flow velocities during atrial contraction and prolonged LV isovolumetric relaxation time. Patients with CKD had significantly reduced CFVR vs. controls (2.74 \u00b1 0.86 vs. 3.40 \u00b1 0.89, P &amp;lt; 0.001), and 43% of patients were classified as having CMD compared with 9% of controls (P = 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with CKD stages 3 and 4, without a diagnosis of heart disease, showed early abnormalities in LV diastolic function that did not fulfil the criteria for LV dysfunction according to current guidelines. A large proportion of CKD patients had CMD, suggesting that microvascular abnormalities may have a pathogenic role in the development of heart failure in this patient group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12878","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T06:40:00Z","timestamp":1594363200000},"page":"2797-2806","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Patients with Moderate Chronic Kidney Disease Without Heart Disease have Reduced Coronary Flow Velocity Reserve"],"prefix":"10.1093","volume":"7","author":[{"given":"Pavlos","family":"Kashioulis","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Medicine\/Nephrology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia Wallentin","family":"Guron","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine\/Nephrology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria K.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Uppsala University , Uppsala ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Hammarsten","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Transfusion Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aso","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine\/Nephrology, Institute of Medicine, Sahlgrenska 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