{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:04:35Z","timestamp":1788307475851,"version":"build-2803163510"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Hypertensive disorders of pregnancy (HDP) are associated with subsequent adverse cardiac remodeling and cardiovascular disease. The role of myocardial microvascular disease among individuals with HDP and left ventricular (LV) remodeling as a potential link to cardiovascular disease is unknown. We aimed to determine whether individuals with HDP history have coronary microvascular dysfunction measured by coronary flow reserve 8 to 10 years after delivery and whether microvascular dysfunction correlates with LV remodeling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Individuals with pregnancies delivered from 2008 to 2010 underwent burst-replenishment myocardial contrast echocardiography (2017\u20132020) to quantify myocardial perfusion at rest and during dobutamine stress. Video intensity versus time data were used to derive \u03b2, the rate of rise of video intensity, a correlate for myocardial blood flow. Coronary flow reserve was calculated as the ratio of \u03b2 at peak stress to \u03b2 at rest, averaged across LV myocardial regions of interest.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              We studied 91 individuals (aged 38\u00b16 and 9.1\u00b10.9 years postdelivery) and 19 with a history of HDP. Individuals with coronary microvascular dysfunction (coronary flow reserve &lt;2.0; n=13) had a higher proportion of HDP (46.2% versus 16.7%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.026) and higher prepregnancy body mass index, baseline heart rate, and hemoglobin A1c compared with those without microvascular dysfunction. The association of coronary flow reserve and HDP was attenuated after adjusting for cardiometabolic factors (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.133). In exploratory subgroup analyses, individuals with both LV remodeling (relative wall thickness &gt;0.42) and HDP (n=12) had the highest proportion of microvascular dysfunction (41.7% versus +HDP-LV remodeling [n=7] 14.3%; \u2212HDP+LV remodeling [n=26] 7.7%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.0498).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>In this small study, HDP history is associated with coronary microvascular dysfunction 1 decade after delivery, findings that may, in part, be driven by metabolic factors including obesity and diabetes. Microvascular dysfunction may contribute to cardiovascular disease among individuals with a history of HDP.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.124.016561","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T18:06:31Z","timestamp":1716314791000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Association of Hypertensive Disorders of Pregnancy With Coronary Microvascular Dysfunction 8 to 10 Years After Delivery"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2535-0309","authenticated-orcid":true,"given":"Malamo E.","family":"Countouris","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, PA (M.E.C., J.Z., X.C., K.L.B., A.C.S., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet M.","family":"Catov","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences (J.M.C., R.E.G.), University of Pittsburgh, PA."},{"name":"Department of Epidemiology (J.M.C.), University of Pittsburgh, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6066-0121","authenticated-orcid":true,"given":"Jianhui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, PA (M.E.C., J.Z., X.C., K.L.B., A.C.S., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"de Jong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (N.d.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2302-5345","authenticated-orcid":true,"given":"Judith","family":"Brands","sequence":"additional","affiliation":[{"name":"Department of Library, Information and Communication Technologies Services and Archive, Enschede, the Netherlands (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xucai","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, PA (M.E.C., J.Z., X.C., K.L.B., A.C.S., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-3277","authenticated-orcid":true,"given":"W. Tony","family":"Parks","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, ON, Canada (W.T.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn L.","family":"Berlacher","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, PA (M.E.C., J.Z., X.C., K.L.B., A.C.S., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2827-5906","authenticated-orcid":true,"given":"Robin E.","family":"Gandley","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences (J.M.C., R.E.G.), University of Pittsburgh, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0542-9466","authenticated-orcid":true,"given":"Adam C.","family":"Straub","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, PA (M.E.C., J.Z., X.C., K.L.B., A.C.S., F.S.V.)."},{"name":"Department of Pharmacology and Chemical Biology (A.C.S.), University of Pittsburgh, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flordeliza S.","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, PA (M.E.C., J.Z., X.C., K.L.B., A.C.S., F.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.03.028"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2015.12.011"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f6564"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.385301.BE"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.003497"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.116.004888"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/10641955.2012.697951"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.048"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198908"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.07.001"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.12.051"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09386"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010647"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000153490.41973.e0"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.853127"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mvr.2020.104104"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.119.14530"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20407"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.18394"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15040"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2015-0225-CC"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003892"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001078"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12451"},{"key":"e_1_3_3_26_2","volume-title":"Development of a Brief Diet Screener for Sodium Intake","author":"Norris J","year":"2012","unstructured":"Norris, J, Block, G, Block, T. 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