{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:53:14Z","timestamp":1793749994837,"version":"4.6.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>There remains limited insight into the pathophysiology and therapeutic advances directed at improving prognosis for patients with heart failure with preserved ejection fraction (HFpEF). Recent studies have suggested a role for coronary microvascular dysfunction in HFpEF. Rb-82 cardiac positron emission tomography imaging is a noninvasive, quantitative approach to measuring myocardial flow reserve (MFR), a surrogate marker for coronary vascular health. The aim of this study was to determine whether abnormalities exist in MFR in patients with HFpEF without epicardial coronary artery disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              A total of 376 patients with ejection fraction \u226550%, no known history of obstructive coronary artery disease, and a confirmed diagnosis of heart failure (n=78) were compared with patients with no evidence of heart failure (n=298), further stratified into those with (n=186) and without (n=112) hypertension. Global and regional left ventricular MFR was calculated as stress\/rest myocardial blood flow using Rb-82 positron emission tomography. Patients with HFpEF were more likely to be older, female, and have comorbid hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, anemia, and renal dysfunction. HFpEF was associated with a significant reduction in global MFR (2.16\u00b10.69 in HFpEF versus 2.54\u00b10.80 in hypertensive controls;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.02 and 2.89\u00b10.70 in normotensive controls;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). A diagnosis of HFpEF was associated with 2.62 times greater unadjusted odds of having low global MFR (defined as &lt;2.0) and remained a significant predictor of reduced global MFR after adjusting for comorbidities.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>HFpEF, in the absence of known history for obstructive epicardial coronary artery disease, is associated with reduced MFR independent of other risk factors.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.115.002562","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T07:08:38Z","timestamp":1468480118000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":140,"title":["Reduced Myocardial Flow in Heart Failure Patients With Preserved Ejection 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Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haissam","family":"Haddad","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Ottawa Heart Institute, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellamae","family":"Stadnick","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Ottawa Heart Institute, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross A.","family":"Davies","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Ottawa Heart Institute, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Chih","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, University of Ottawa Heart Institute, Ontario, 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