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

doi:10.1002/ehf2.12170

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

Medicine, Cardiology Division

Research output: Contribution to journal › Article › peer-review

7 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 language	English (US)
Pages (from-to)	645-648
Number of pages	4
Journal	ESC Heart Failure
Volume	4
Issue number	4
DOIs	https://doi.org/10.1002/ehf2.12170
State	Published - Nov 2017

Keywords

Heart failure with preserved ejection fraction
Microvascular dysfunction

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/ehf2.12170

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

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.",

keywords = "Heart failure with preserved ejection fraction, Microvascular dysfunction",

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T1 - Microvascular dysfunction and cardiac fibrosis in heart failure with preserved ejection fraction

T2 - a case report

AU - Narang, Nikhil

AU - Medvedofsky, Diego

AU - Dryer, Kathryn

AU - Shah, Sanjiv J.

AU - Davidson, Charles J.

AU - Patel, Amit R.

AU - Blair, John E.A.

PY - 2017/11

Y1 - 2017/11

N2 - 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.

AB - 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.

KW - Heart failure with preserved ejection fraction

KW - Microvascular dysfunction

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

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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