{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:05:26Z","timestamp":1792209926970,"version":"4.4.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Coronary microvascular dysfunction (CMD) is involved in heart failure (HF) onset and progression, independently of HF phenotype and obstructive coronary artery disease. Invasive assessment of CMD might provide insights into phenotyping and prognosis of patients with HF. We aimed to assess absolute coronary flow, absolute microvascular resistance, myocardial perfusion, coronary flow reserve, and microvascular resistance reserve in patients with HF with preserved ejection fraction and HF with reduced ejection fraction (HFrEF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Single-center, prospective study of 56 consecutive patients with de novo HF with nonobstructive coronary artery disease divided into HF with preserved ejection fraction (n=21) and HFrEF (n=35). CMD was invasively assessed by continuous intracoronary thermodilution and defined as coronary flow reserve &lt;2.5. Left ventricular and left anterior descending artery\u2013related myocardial mass was quantified by echocardiography and coronary computed tomography angiography. Myocardial perfusion (mL\/min per g) was calculated as the ratio between absolute coronary flow and left anterior descending artery\u2013related mass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Patients with HFrEF showed a higher left ventricular and left anterior descending artery\u2013related myocardial mass compared with HF with preserved ejection fraction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.010). Overall, 52% of the study population had CMD, with a similar prevalence between the 2 groups. In HFrEF, CMD was characterized by lower absolute microvascular resistance and higher absolute coronary flow at rest (functional CMD;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002). CMD was an independent predictor of a lower rate of left ventricular reverse remodeling at follow-up. In patients with HF with preserved ejection fraction, CMD was mainly due to higher absolute microvascular resistance and lower absolute coronary flow during hyperemia (structural CMD;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u22640.030).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Continuous intracoronary thermodilution allows the definition and characterization of patterns with distinct CMD in patients with HF and could identify patients with HFrEF with a higher rate of left ventricular reverse remodeling at follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.123.010805","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T05:00:17Z","timestamp":1702875617000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Coronary Microvascular Dysfunction in Patients With Heart Failure: Characterization of Patterns in HFrEF Versus HFpEF"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7017-778X","authenticated-orcid":true,"given":"Pasquale","family":"Paolisso","sequence":"first","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Hospital, Belgium (P.P., E.G., M.B., D.T.B., K.B., C.D.C., M.S., A.L., G.E., D.F., A.M., L.D., M.P., B.D.B., J.B., M.V.)."},{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (P.P., M.B., D.T.B., C.D.C., A.L., G.E., D.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5519-2818","authenticated-orcid":true,"given":"Emanuele","family":"Gallinoro","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Hospital, Belgium (P.P., E.G., M.B., D.T.B., K.B., C.D.C., M.S., A.L., G.E., D.F., A.M., L.D., M.P., B.D.B., J.B., M.V.)."},{"name":"Cardiology Unit, Galeazzi-Sant\u2019Ambrogio Hospital, Scientific Institute for Research, Hospitalization, and Health Care (IRCCS), Milan, Italy (E.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9777-8104","authenticated-orcid":true,"given":"Marta","family":"Belmonte","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Hospital, Belgium (P.P., E.G., M.B., D.T.B., K.B., C.D.C., M.S., A.L., G.E., D.F., A.M., L.D., M.P., B.D.B., J.B., M.V.)."},{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (P.P., M.B., D.T.B., C.D.C., A.L., G.E., D.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9640-017X","authenticated-orcid":true,"given":"Dario Tino","family":"Bertolone","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Hospital, Belgium (P.P., E.G., M.B., D.T.B., K.B., C.D.C., M.S., A.L., G.E., D.F., A.M., L.D., M.P., B.D.B., J.B., M.V.)."},{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (P.P., M.B., D.T.B., C.D.C., A.L., G.E., D.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Bermpeis","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Hospital, Belgium (P.P., E.G., M.B., D.T.B., K.B., C.D.C., M.S., A.L., G.E., D.F., A.M., L.D., M.P., B.D.B., J.B., M.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"De 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