{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:04:36Z","timestamp":1781766276098,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007048","name":"Mayo Foundation for Medical Education and Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007048","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2022,1,9]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pulse pressure (PP), a raw index of arterial stiffness, is inversely related to coronary microvascular function, even among patients with non-obstructive coronary artery disease (CAD), as per non-invasive studies. We aimed to determine whether invasive aortic PP is associated with coronary microvascular endothelial dysfunction (CMED) and\/or coronary microvascular endothelial independent dysfunction (CMEID) in patients with non-obstructed CAD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively analysed a cohort of 1894 patients (mean age, 51.2 years; 1261 (66.6%) women) who presented with chest pain and non-obstructive CAD (angiographic stenosis &lt;50%); coronary vasoreactivity was assessed in the mid-left anterior descending artery. The patients were classified based on whether aortic PP was high (\u226550 mm Hg). CMEID was defined as abnormal coronary flow reserve (&lt;2.5) or hyperaemic myocardial resistance (&gt;2.0 mm Hg\/cm\/s), CMED was defined as abnormal acetylcholine-induced per cent change of coronary blood flow (\u226450%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients with high aortic PP had a higher rate of CMEID than those with low aortic PP (40.9 vs 25.2%, p&lt;0.001). Conversely, aortic PP was not associated with CMED. On multivariate analysis, high aortic PP was associated with CMEID occurrence (OR 1.42, 95% CI 1.13 to 1.78; p=0.003). On follow-up (median, 150 months), all-cause death was more frequent among patients with vs without high aortic PP (20.1% vs 7.3%, log-rank p&lt;0.001) and HR was 2.08 (95% CI 1.34 to 3.32, p=0.002) on multivariate cox regression analysis. Furthermore, among patients with low aortic PP, CMEID was an independent risk factor for all-cause mortality (HR 2.04, 95% CI 1.01 to 4.16, p=0.048).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with non-obstructive CAD, invasive aortic PP was significantly associated with CMEID, but not with CMED. High aortic PP was an independent predictor of all-cause mortality, but CMEID was an independent risk factor in patients with low aortic PP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001925","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T12:01:45Z","timestamp":1643716905000},"page":"e001925","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of invasive aortic pulse pressure on coronary microvascular endothelial-independent dysfunction and on mortality in non-obstructive coronary artery disease"],"prefix":"10.1136","volume":"9","author":[{"given":"Hyun Woong","family":"Park","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Department of Cardiovascular Disease, Chungnam National University Sejong Hospital, Sejong, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Corban","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Toya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Division of Cardiology, National Defense Medical College, Tokorozawa, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilke","family":"Ozcan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3271-3887","authenticated-orcid":false,"given":"Lilach","family":"Lerman","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9446-5313","authenticated-orcid":false,"given":"Amir","family":"Lerman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,2,1]]},"reference":[{"key":"2025081711184400000_9.1.e001925.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.01.157"},{"key":"2025081711184400000_9.1.e001925.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000298"},{"key":"2025081711184400000_9.1.e001925.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.34.3.372"},{"key":"2025081711184400000_9.1.e001925.4","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.089078"},{"key":"2025081711184400000_9.1.e001925.5","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.36.4.489"},{"key":"2025081711184400000_9.1.e001925.6","unstructured":"WW N , OR MF . 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