{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:06:19Z","timestamp":1767773179706,"version":"3.40.5"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T00:00:00Z","timestamp":1584057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Coronary vascular dysfunction, as assessed by coronary flow reserve (CFR) in the left anterior descending coronary artery, is found in various conditions including end\u2010stage chronic kidney disease (CKD). Currently, we investigated the associations of CFR with echocardiographic indices of systolic and diastolic cardiac function and identified independent predictors of CFR in hemodialysis patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>End\u2010stage CKD patients treated with hemodialysis (n\u00a0=\u00a029) without known cardiovascular disease were recruited from a Hemodialysis Unit in Northwestern Greece. A thorough echocardiographic evaluation including CFR measurement following dipyridamole infusion was performed in all participants. Arterial stiffness was assessed by measurement of carotid\u2013femoral pulse wave velocity and aortic augmentation index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the patients was 63\u00a0years, and mean duration of hemodialysis was 2.9\u00a0years. CFR was 1.60\u00a0\u00b1\u00a00.37 while dipyridamole caused a significant increase in <jats:italic>E<\/jats:italic>'<jats:sub>sep<\/jats:sub>, <jats:italic>S<\/jats:italic><jats:sub>lat<\/jats:sub>, <jats:italic>E<\/jats:italic>'<jats:sub>lat<\/jats:sub>, and Stroke volume (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05 for all). Independent predictors of CFR were posterior wall thickness (<jats:italic>B<\/jats:italic> \u22120.408, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.013) and dipyridamole\u2010induced changes in Tei index (<jats:italic>B<\/jats:italic> \u22120.425, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.007). A severely decreased CFR\u00a0&lt;\u00a01.5 was observed in 52% of the patients. <jats:italic>E<\/jats:italic>\/<jats:italic>E<\/jats:italic>' ratio (<jats:italic>B<\/jats:italic> 10.84, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.014) was the single independent predictor of severely decreased CFR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In end\u2010stage CKD patients on hemodialysis without known cardiovascular disease, impaired coronary vascular function was prevalent and related to increased left ventricular wall thickness, increased filling pressures, and dipyridamole\u2010induced deteriorated myocardial function independently of the presence of wall\u2010motion abnormalities. Further studies are required to clarify the prognostic role of dipyridamole\u2010induced cardiac changes in hemodialysis patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14625","type":"journal-article","created":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T11:45:25Z","timestamp":1584099925000},"page":"536-545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impaired coronary microcirculation is associated with left ventricular diastolic dysfunction in end\u2010stage chronic kidney disease patients"],"prefix":"10.1111","volume":"37","author":[{"given":"Nikos","family":"Papamichail","sequence":"first","affiliation":[{"name":"2nd Department of Cardiology and Michaelidion Cardiac Center Medical School University of Ioannina Ioannina 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Department of Cardiology and Michaelidion Cardiac Center Medical School University of Ioannina Ioannina Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chariklia","family":"Gouva","sequence":"additional","affiliation":[{"name":"Department of Nephrology General Hospital of Arta Arta Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kostas","family":"Katopodis","sequence":"additional","affiliation":[{"name":"Department of Nephrology General Hospital of Arta Arta Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lampros K.","family":"Michalis","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology and Michaelidion Cardiac Center Medical School University of Ioannina Ioannina Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katerina K.","family":"Naka","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology and Michaelidion Cardiac Center Medical School 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