{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:14:42Z","timestamp":1791407682792,"version":"4.3.3"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Coronary microvascular disease (CMD) may be part of a systemic small vessel disease that also manifests as neurological impairment and kidney disease. However, clinical evidence supporting a potential link is scarce. We assessed whether CMD is associated with an increased risk of small vessel disease in the kidney and brain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A retrospective multicenter (n=3) study of patients clinically referred to 82\u2010rubidium positron emission tomography myocardial perfusion imaging was conducted between January 2018 and August 2020. Exclusion criterion was reversible perfusion defects &gt;5%. CMD was defined as myocardial flow reserve (MFR) \u22642. The primary outcome, microvascular event, was defined by hospital contact for chronic kidney disease, stroke, or dementia. Among 5122 patients, 51.7% were men, median age 69.0 [interquartile range, 60.0\u201375.0] years, 11.0% had left ventricular ejection fraction \u226440%, and 32.4% had MFR \u22642. MFR was associated with baseline estimated glomerular filtration rate after multivariable adjustment (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =0.04 [95% CI, 0.03\u20130.05];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). During a median follow\u2010up of 3.05\u2009years, 383 (7.5%) patients suffered an event (253 cerebral and 130 renal), more frequently in patients with MFR \u22642 versus MFR &gt;2 (11.6% versus 5.5%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). MFR \u22642 was associated to outcome with a hazard ratio (HR) of 2.30 (95% CI, 1.88\u20132.81,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and an adjusted HR of 1.62 (95% CI, 1.32\u20132.00,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Results were consistent across subgroups defined by presence of irreversible perfusion defects, estimated glomerular filtration rate, diabetes, left ventricular ejection fraction, and previous revascularization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This is the first large\u2010scale cohort study to link CMD to microvascular events in the kidney and brain. Data support the hypothesis that CMD is part of a systemic vascular disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.028767","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T06:28:46Z","timestamp":1686810526000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Coronary Microvascular Disease Assessed by 82\u2010Rubidium Positron Emission Tomography Myocardial Perfusion Imaging Is Associated With Small Vessel Disease of the Kidney and Brain"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4693-6352","authenticated-orcid":false,"given":"Signe","family":"H\u00f8jstrup","sequence":"first","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0851-5095","authenticated-orcid":false,"given":"Kim W.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5058-8311","authenticated-orcid":false,"given":"Ulrik","family":"Talleruphuus","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5843-5742","authenticated-orcid":false,"given":"Lisbeth","family":"Marner","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1015-7322","authenticated-orcid":false,"given":"S\u00f8ren","family":"Galatius","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3002-353X","authenticated-orcid":false,"given":"Maira","family":"Rauf","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-0041","authenticated-orcid":false,"given":"Louise H.","family":"Bjerking","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2522-9253","authenticated-orcid":false,"given":"Lars","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8740-4862","authenticated-orcid":false,"given":"Evald H.","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6900-8794","authenticated-orcid":false,"given":"Kirsten","family":"Bouchelouche","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine &amp; PET Center Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7472-3194","authenticated-orcid":false,"given":"Hanne","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Neurology Copenhagen University Hospital, Bispebjerg and Frederiksberg Frederiksberg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4134-0349","authenticated-orcid":false,"given":"Eva I. 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