{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1360294647501546112.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1002/ejhf.2010"}},{"identifier":{"@type":"URI","@value":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/ejhf.2010"}},{"identifier":{"@type":"URI","@value":"https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ejhf.2010"}},{"identifier":{"@type":"PMID","@value":"33247863"}},{"identifier":{"@type":"HANDLE","@value":"20.500.14017/e9eadeaa-4560-467b-9b18-921e44c8fcb4"}},{"identifier":{"@type":"HANDLE","@value":"1942/32874"}}],"dc:title":[{"@value":"Coronary microvascular dysfunction is associated with exertional haemodynamic abnormalities in patients with heart failure with preserved ejection fraction"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:sec>\n                    <jats:title>Aims</jats:title>\n                    <jats:p>This study uniquely explored the relationship between coronary microvascular function and exercise haemodynamics using concurrent invasive testing.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results</jats:title>\n                    <jats:p>\n                      Fifty‐one consecutive patients with unexplained cardiac exertion symptoms, non‐obstructive coronary artery disease and normal left ventricular ejection fraction (>50%) underwent haemodynamic exercise assessment and concurrent coronary reactivity testing. Heart failure with preserved ejection fraction (HFpEF) was defined as a pulmonary arterial wedge pressure (PAWP) ≥15 mmHg at rest and/or ≥25 mmHg at peak exercise. Endothelium‐independent coronary microvascular dysfunction (CMD) was defined as a coronary flow reserve (CFR) ≤2.5, while endothelium‐dependent CMD was defined as ≤50% increase in coronary blood flow (CBF) in response to intracoronary acetylcholine infusions. Patients with HFpEF (\n                      <jats:italic>n</jats:italic>\n                       = 22) had significantly lower CFR (2.5 ± 0.6 vs. 3.2 ± 0.7;\n                      <jats:italic>P</jats:italic>\n                       = 0.0003) and median %CBF increase in response to intracoronary acetylcholine [1 (−35; 34) vs. 64 (−4; 133);\n                      <jats:italic>P</jats:italic>\n                       = 0.002] compared to patients without HFpEF (\n                      <jats:italic>n</jats:italic>\n                       = 29). PAWP was significantly higher in patients with endothelium‐independent CMD compared to controls during both rest and exercise. This significant elevation was only present during exercise in patients with endothelium‐dependent CMD compared to controls. CFR had significant inverse correlations with PAWP at rest (r = −0.31;\n                      <jats:italic>P</jats:italic>\n                       = 0.03) and peak exercise (r = −0.47,\n                      <jats:italic>P</jats:italic>\n                       = 0.001). CFR also had positive correlations with maximal exercise capacity (in W/kg) (r = 0.33,\n                      <jats:italic>P</jats:italic>\n                       = 0.02).\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Coronary microvascular function is inversely associated with filling pressures, particularly during exercise. Both types of CMD are associated with higher filling pressures at peak exercise. These findings underscore the potential mechanism and therapeutic target for CMD and HFpEF.</jats:p>\n                  </jats:sec>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1380294647501546117","@type":"Researcher","foaf:name":[{"@value":"Ali Ahmad"}],"jpcoar:affiliationName":[{"@value":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1380294647501546115","@type":"Researcher","foaf:name":[{"@value":"Michel T. Corban"}],"jpcoar:affiliationName":[{"@value":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1380294647501546114","@type":"Researcher","foaf:name":[{"@value":"Takumi Toya"}],"jpcoar:affiliationName":[{"@value":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN USA"},{"@value":"Division of Cardiology National Defense Medical College  Tokorozawa Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1380294647501545984","@type":"Researcher","foaf:name":[{"@value":"Frederik H. Verbrugge"}],"jpcoar:affiliationName":[{"@value":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN USA"},{"@value":"Biomedical Research Institute, Faculty of Medicine and Life Sciences Hasselt University  Hasselt Belgium"}]},{"@id":"https://cir.nii.ac.jp/crid/1380294647501545985","@type":"Researcher","foaf:name":[{"@value":"Jaskanwal D. Sara"}],"jpcoar:affiliationName":[{"@value":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1380294647501546112","@type":"Researcher","foaf:name":[{"@value":"Lilach O. Lerman"}],"jpcoar:affiliationName":[{"@value":"Division of Nephrology and Hypertension Mayo Clinic  Rochester MN USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1380294647501546113","@type":"Researcher","foaf:name":[{"@value":"Barry A. Borlaug"}],"jpcoar:affiliationName":[{"@value":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN USA"}]},{"@id":"https://cir.nii.ac.jp/crid/1380294647501546116","@type":"Researcher","foaf:name":[{"@value":"Amir Lerman"}],"jpcoar:affiliationName":[{"@value":"Department of Cardiovascular Medicine Mayo Clinic  Rochester MN USA"}]}],"contributor":[{"@id":"https://cir.nii.ac.jp/crid/1890020692620241668","@type":"Researcher","foaf:name":[{"@value":"Clinical sciences"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241667","@type":"Researcher","foaf:name":[{"@value":"Medicine and Pharmacy academic/administration"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241674","@type":"Researcher","foaf:name":[{"@value":"Cardiology"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241672","@type":"Researcher","foaf:name":[{"@value":"Verbrugge, Frederik Hendrik/0000-0003-0599-9290; Ahmad,"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241665","@type":"Researcher","foaf:name":[{"@value":"Intensive Care"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241679","@type":"Researcher","foaf:name":[{"@value":"Ali/0000-0001-9669-8009"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241675","@type":"Researcher","foaf:name":[{"@value":"Sara, Jaskanwal D."}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241676","@type":"Researcher","foaf:name":[{"@value":"VERBRUGGE, Frederik"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241669","@type":"Researcher","foaf:name":[{"@value":"Lerman, Lilach O."}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241677","@type":"Researcher","foaf:name":[{"@value":"Toya, Takumi"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241666","@type":"Researcher","foaf:name":[{"@value":"Corban, Michel T."}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241683","@type":"Researcher","foaf:name":[{"@value":"Ahmad, Ali"}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241673","@type":"Researcher","foaf:name":[{"@value":"Borlaug, Barry A."}]},{"@id":"https://cir.nii.ac.jp/crid/1890020692620241664","@type":"Researcher","foaf:name":[{"@value":"Lerman, Amir"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13889842"},{"@type":"EISSN","@value":"18790844"}],"prism:publicationName":[{"@value":"European Journal of Heart Failure"}],"dc:publisher":[{"@value":"Oxford University Press (OUP)"}],"prism:publicationDate":"2020-10-07","prism:volume":"23","prism:number":"5","prism:startingPage":"765","prism:endingPage":"772"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","dc:rights":["http://onlinelibrary.wiley.com/termsAndConditions#vor"],"url":[{"@id":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/ejhf.2010"},{"@id":"https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ejhf.2010"}],"createdAt":"2020-09-19","modifiedAt":"2026-01-06","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=heart%20failure%20with%20preserved%20ejection%20fraction","dc:title":"heart failure with preserved ejection fraction"},{"@id":"https://cir.nii.ac.jp/all?q=Heart%20Failure","dc:title":"Heart Failure"},{"@id":"https://cir.nii.ac.jp/all?q=Hemodynamics","dc:title":"Hemodynamics"},{"@id":"https://cir.nii.ac.jp/all?q=Myocardial%20Ischemia","dc:title":"Myocardial Ischemia"},{"@id":"https://cir.nii.ac.jp/all?q=Stroke%20Volume","dc:title":"Stroke Volume"},{"@id":"https://cir.nii.ac.jp/all?q=Ventricular%20Function,%20Left","dc:title":"Ventricular Function, Left"},{"@id":"https://cir.nii.ac.jp/all?q=Heart%20failure%20with%20preserved%20ejection%20fraction","dc:title":"Heart failure with preserved ejection fraction"},{"@id":"https://cir.nii.ac.jp/all?q=Exercise%20haemodynamics","dc:title":"Exercise haemodynamics"},{"@id":"https://cir.nii.ac.jp/all?q=Microvascular%20dysfunction","dc:title":"Microvascular dysfunction"},{"@id":"https://cir.nii.ac.jp/all?q=Humans","dc:title":"Humans"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360576118838353792","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Role of Inflammation in Coronary Epicardial and Microvascular Dysfunction"}]},{"@id":"https://cir.nii.ac.jp/crid/1360857593816153472","@type":"Article","resourceType":"学術雑誌論文(journal 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