ArticlePloS one2020
N-Terminal pro-B-type natriuretic peptide and coronary microvascular dysfunction in women with preserved ejection fraction: A report from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The trial behind it
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Who cites it
11 citing papers in PubMed, 10 citations in OpenAlex.
- Association between NT-pro-BNP levels and endothelial dysfunction assessed by digital thermal monitoring in patients with coronary artery disease.Frontiers in cardiovascular medicine · 2026Article
- Coronary microvascular disease in heart failure with preserved ejection fraction.Physiological reports · 2025Review
- Incident heart failure and recurrent coronary events following acute myocardial infarction.European heart journal · 2025Article
- Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine.American heart journal plus : cardiology research and practice · 2025Article
- Impact of Sex in the Incidence of Heart Failure in Patients with Chronic Coronary Syndrome.Current heart failure reports · 2024Review
- Circulating plasma NT-proBNP predicts subclinical coronary atherosclerosis on CT angiography among older adults in Uganda.BMC research notes · 2023Article
- Latest from the WISE: Contributions to the Understanding of Ischemia and Heart Failure among Women with No Obstructive Coronary Arteries.Reviews in cardiovascular medicine · 2023Review
- Ischemia and no obstructive coronary arteries (INOCA): A narrative review.Atherosclerosis · 2022Review
- Gut dysbiosis and age-related neurological diseases in females.Neurobiology of disease · 2022Review
- Even "WISE-R?"-an Update on the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation.Current atherosclerosis reports · 2020Review
- Women's health: making cardiovascular disease real.Current opinion in cardiology · 2018Review
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundWomen with symptoms and signs of ischemia, preserved left ventricular ejection fraction (LVEF), and no obstructive coronary artery disease (CAD), often have coronary microvascular dysfunction (CMD), and are at risk of future heart failure with preserved ejection fraction (HFpEF). N-terminal pro-B-type natriuretic peptide (NT-proBNP) is used to evaluate HF and myocardial ischemia. Relationships between NT-proBNP and CMD are not well defined in this population.
methodsWe evaluated resting NT-proBNP levels in 208 women with symptoms and signs of ischemic heart disease, preserved LVEF and no obstructive CAD undergoing clinically indicated invasive coronary flow reserve (CFR) as a measure of CMD-related ischemia and resting left ventricular end-diastolic pressure (LVEDP). Chi-square testing was used for categorical variables and ANOVA or Kruskal-Wallis tests were used for continuous variables.
resultsOverall, 79% had an elevated resting LVEDP, and mean NT-proBNP was 115 ± 158 pg/mL. NT-proBNP levels correlated directly with age (r = 0.28, p = <0.0001), and indirectly with body mass index (r = -0.21, p = 0.0006), but did not independently associate with CFR. When stratified by NT-proBNP thresholds, higher NT-proBNP was initially associated with lower CFR, which did not persist with adjustment for multiple testing (p = 0.01 and 0.36, respectively).
conclusionAmong women with symptoms and signs of ischemia, preserved LVEF, no obstructive CAD, and undergoing clinically indicated functional coronary angiography (FCA) for suspected CMD, while a majority had elevated resting LVEDP, we failed to find an independent association between CFR and NT-proBNP, although stratified clinical thresholds may relate to lower CFR. Further work is needed to investigate if these findings support the hypothesis that CMD-related ischemia may be a precursor to HFpEF.
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