ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2021
Cardiovascular magnetic resonance assessment of coronary flow reserve improves risk stratification in heart failure with preserved ejection fraction.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Impact of coronary microvascular dysfunction in heart failure with preserved ejection fraction: a meta-analysis.ESC heart failure · 2024Pooled it
- Coronary flow reserve evaluated by phase-contrast cine cardiovascular magnetic resonance imaging of coronary sinus: a meta-analysis.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2023Pooled it
- Impaired Coronary Microcirculation and Myocardial Systolic Function: A Narrative Review on Non-Invasive Assessment in Cardiovascular Diseases.Life (Basel, Switzerland) · 2025Review
- Atrial dysfunction: a contrast-free marker for HFpEF in obese diabetics-insights from comprehensive CMR and serum biomarker analyses.Cardiovascular diabetology · 2025Article
- The role of coronary microcirculation in heart failure with preserved ejection fraction: An unceasing odyssey.Heart failure reviews · 2025Review
- Effect of sodium-glucose Co-transporter 2 inhibitors on coronary microcirculation.Frontiers in pharmacology · 2025Review
- Coronary Microvascular Dysfunction: Insights on Prognosis and Future Perspectives.Reviews in cardiovascular medicine · 2025Review
- CMR to characterize myocardial structure and function in heart failure with preserved left ventricular ejection fraction.European heart journal. Cardiovascular Imaging · 2024Review
- Clinical Updates in Coronary Artery Disease: A Comprehensive Review.Journal of clinical medicine · 2024Review
- Microvascular Dysfunction across the Spectrum of Heart Failure Pathology: Pathophysiology, Clinical Features and Therapeutic Implications.International journal of molecular sciences · 2024Review
- Timing of Regadenoson-induced Peak Hyperemia and the Effects on Coronary Flow Reserve.medRxiv : the preprint server for health sciences · 2024Article
- The Role of Non-Invasive Multimodality Imaging in Chronic Coronary Syndrome: Anatomical and Functional Pathways.Diagnostics (Basel, Switzerland) · 2023Review
- Coronary Microvascular Dysfunction: Features and Prognostic Value.Journal of clinical medicine · 2023Article
- 2021-2022 state of our JCMR.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2022Review
- Quantitative myocardial perfusion during stress using CMR is impaired in healthy Middle Eastern immigrants without CV risk factors.Scientific reports · 2022Article
- The Role of Systemic Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction.Biomolecules · 2022Review
- Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction: Pathophysiology, Assessment, Prevalence and Prognosis.Cardiac failure review · 2022Review
- Needle-free myocardial blood flow and reserve quantification using artificial intelligence-enhanced coronary sinus flow magnetic resonance imaging with exercise cardiovascular magnetic resonance.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic ResonanceArticle
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary microvascular dysfunction (CMD) has been proposed as a novel mechanism for the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). Recent studies have suggested the potential utility of coronary flow reserve (CFR) as a marker of CMD in patients with HFpEF. Phase contrast (PC) cine cardiovascular magnetic resonance (CMR) of the coronary sinus has emerged as a non-invasive method to quantify CFR. We aimed to investigate the prognostic value of CMR-derived CFR in patients with HFpEF.
methodsData from 163 HFpEF patients (73 ± 9 years; 86 [53%] female) were retrospectively analyzed. Coronary sinus blood flow was measured in all patients, and myocardial blood flow was calculated as coronary sinus blood flow divided by left ventricular mass. CFR was calculated as the myocardial blood flow during adenosine triphosphate infusion divided by that at rest. Adverse events were defined as all-cause death and hospitalization due to HF exacerbation. Event-free survival stratified according to CFR < 2.0 was estimated with Kaplan-Meier survival methods and Log-rank test.
resultsDuring a median follow-up of 4.1 years, 26 patients (16%) experienced adverse events. CMR-derived CFR was significantly lower in HFpEF with adverse events compared with those without (1.93 ± 0.38 vs. 2.67 ± 0.52, p < 0.001). On a Kaplan Meier curve, the rates of adverse events were significantly higher in HFpEF patients with CFR < 2.0 compared with HFpEF with CFR ≥ 2.0 (p < 0.001). The area under the curve of CFR for predicting adverse events was significantly higher than that of LGE (0.881 vs. 0.768, p = 0.037) and GLS (0.881 vs. 0.747, p = 0.036).
conclusionsCFR assessed using coronary sinus PC cine CMR may be useful as a non-invasive prognostic marker for HFpEF patients.
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