{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:01:48Z","timestamp":1791259308563,"version":"4.1.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":444,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:00:00Z","timestamp":1722124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Department of Internal Medicine at Herlev Hospital"},{"name":"Research Council of Herlev Hospital"},{"DOI":"10.13039\/100007405","name":"The Danish Heart Foundation","doi-asserted-by":"crossref","award":["16-R107-A6697"],"award-info":[{"award-number":["16-R107-A6697"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009910","name":"The Hartmann Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009910","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009584","name":"The Toyota Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009584","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Steno Collaborative Grant 2018"},{"DOI":"10.13039\/100009584","name":"Toyota Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009584","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Patients with type 2 diabetes (T2D) have a high prevalence of diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF), which in turn leads to an increased risk of hospitalization and death. However, the factors of risk and their relative importance in leading to higher left ventricular filling pressures are still disputed. We sought to clarify the associations of a wide range of invasive and non-invasive risk factors with cardiac filling pressures in high-risk T2D patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with T2D at high risk of cardiovascular events were prospectively enrolled in this study. Participants were thoroughly phenotyped including right heart catheterization at rest and during exercise, echocardiography, urinary excretion of albumin (UACR), and quantification of their myocardial blood flow rate (MFR) using cardiac 82Rb-PET\/CT. Of the 37 patients included in the study, 22 (59%) patients met invasive criteria for HFpEF. Only 2 out of 39 variables emerged as independent factors associated with left ventricular filling pressure as assessed by pulmonary capillary wedge pressure (PCWP) at rest; history of hypertension (coefficient: 2.6 mmHg [0.3; 5.0], P = 0.030) and MFR (P = 0.026). We found a significant inverse association between MFR and PCWP with a coefficient of \u22122.3 mmHg (\u22124.3; \u22120.3) in PCWP per integer change of MFR. The MFR ranged from 1.18 to 3.68 in our study, which corresponds to a difference in PCWP of approximately 6 mmHg between patients with the lowest compared to the highest MFR. During exercise, only 2 variables emerged as borderline independent factors associated with PCWP: myocardial flow reserve (coefficient: \u22124.4 [\u22129.6; 0.8], P = 0.091) and beta-blockers use (coefficient: 6.1 [\u22120.1; 12.4], P = 0.053).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with type 2 diabetes without known HFpEF but risk factors for cardiovascular disease, myocardial blood flow rate was independently associated with PCWP at rest across the range from normal to abnormal left heart filling pressures. A clinically significant difference of 6 mmHg in PWCP was attributable to differences in MFR in patients with the lowest compared with the highest MFR values. This suggests that strategies than attenuate microvascular dysfunction could slow progression of increased left ventricular left heart filling pressures in patients at increased risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14929","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T02:43:35Z","timestamp":1722221015000},"page":"3551-3558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Coronary Microvascular Dysfunction and Left Heart Filling Pressures in Patients with Type 2 Diabetes"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6064-062X","authenticated-orcid":false,"given":"Emil","family":"Wolsk","sequence":"first","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte Hospital , Copenhagen ,","place":["Denmark"]},{"name":"Department of Cardiology, Rigshospitalet , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel","family":"J\u00fcrgens","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Rigshospitalet , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Schou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte Hospital , Copenhagen ,","place":["Denmark"]},{"name":"Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital, Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mads","family":"Ersb\u00f8ll","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Hasbak","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital, Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Kjaer","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital, Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zerahn","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen , Herlev ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"H\u00f8gh Brandt","sequence":"additional","affiliation":[{"name":"Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen , Herlev ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Haulund G\u00e6de","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Endocrinology, Slagelse Hospital , Slagelse ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen , Herlev ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen , Herlev ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Michaela","family":"Kistorp","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Rigshospitalet , Copenhagen ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet , Copenhagen 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