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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Microvascular dysfunction in patients with heart failure with preserved ejection fraction: A meta-analysis
Mai Azuma1, Shingo Kato2, Kazuki Fukui1
1Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
Microcirculation (New York, N.Y. : 1994)
|July 26, 2023
Summary
Microvascular dysfunction (MVD) affects over 50% of patients with heart failure with preserved ejection fraction (HFpEF). This condition significantly impacts patient prognosis and is a key factor in HFpEF pathophysiology.
Area of Science:
- Cardiology
- Internal Medicine
- Pathophysiology
Background:
- Microvascular dysfunction (MVD) is a suspected key factor in heart failure with preserved ejection fraction (HFpEF).
- The exact prevalence and prognostic significance of MVD in HFpEF patients remain unclear.
- Understanding MVD's role is crucial for improving HFpEF management.
Purpose of the Study:
- To determine the frequency of MVD in patients diagnosed with HFpEF.
- To assess the prognostic value of MVD in HFpEF patients.
- To evaluate MVD's utility in risk stratification for HFpEF.
Main Methods:
- A meta-analysis was conducted using data from 9 studies, including 941 HFpEF patients.
- Literature searches were performed across major databases (PubMed, Web of Science, Cochrane, Embase).
- Prevalence was calculated using the general inverse variance method; prognostic associations were reviewed comprehensively.
Main Results:
- The meta-analysis found MVD present in 55.5% of HFpEF patients (95% CI: 34.8%-76.2%), with high heterogeneity.
- Four out of five studies examining prognosis reported a significant association between MVD and adverse outcomes.
- Significant heterogeneity (I² = 98%) was noted in the prevalence data.
Conclusions:
- Approximately half of HFpEF patients exhibit microvascular dysfunction.
- MVD presence is significantly linked to poorer prognosis in HFpEF.
- MVD is a critical pathophysiological component in heart failure with preserved ejection fraction.
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