Microvascular dysfunction and cardiac fibrosis in heart failure with preserved ejection fraction: a case report

Nikhil Narang, Diego Medvedofsky, Kathryn Dryer, Sanjiv J. Shah, Charles J. Davidson, Amit R. Patel, John E.A. Blair*

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis. This case exhibits a potential HFpEF phenotype associated with microvascular dysfunction, fibrosis, and elevated filling pressures.

Original languageEnglish (US)
Pages (from-to)645-648
Number of pages4
JournalESC Heart Failure
Volume4
Issue number4
DOIs
StatePublished - 2017

Keywords

  • Heart failure with preserved ejection fraction
  • Microvascular dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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