Ryan E. Wilson, Lindsay Burton, Noah Marini, Peter Loewen, Robert Janke, Noorat Aujla, Dresya Davis, Kathy L. Rush
{"title":"Assessing the impact of atrial fibrillation self-care interventions: A systematic review","authors":"Ryan E. Wilson, Lindsay Burton, Noah Marini, Peter Loewen, Robert Janke, Noorat Aujla, Dresya Davis, Kathy L. Rush","doi":"10.1016/j.ahjo.2024.100404","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100404","url":null,"abstract":"<div><p>This systematic review evaluates the efficacy of self-care interventions for atrial fibrillation (AF), focusing on strategies for maintenance, monitoring, and management applied individually or in combination. Adhering to the 2020 PRISMA guidelines, the search strategy spanned literature from 2005 to 2023, utilizing keywords and subject headings for “atrial fibrillation” and “self-care” combined with the Boolean operator AND. The databases searched included Medline, Embase, and CINAHL. The initial search, conducted on February 17, 2021, and updated on May 16, 2023, identified 5160 articles, from which 2864 unique titles and abstracts were screened. After abstract screening, 163 articles were reviewed in full text, resulting in 27 articles being selected for data extraction; these studies comprised both observational and randomized controlled trial designs. A key finding in our analysis reveals that self-care interventions, whether singular, dual, or integrated across all three components, resulted in significant improvements across patient-reported, clinical, and healthcare utilization outcomes compared to usual care. Educational interventions, often supported by in-person sessions or telephone follow-ups, emerged as a crucial element of effective AF self-care. Additionally, the integration of mobile and web-based technologies alongside personalized education showed promise in enhancing outcomes, although their full potential remains underexplored. This review highlights the importance of incorporating comprehensive, theory-informed self-care interventions into routine clinical practice and underscores the need for ongoing innovation and the implementation of evidence-based strategies. The integration of education and technology in AF self-care aligns with the recommendations of leading health organizations, advocating for patient-centered, technology-enhanced approaches to meet the evolving needs of the AF population.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"43 ","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000478/pdfft?md5=ebe8573c15be90402980809d2f18dbf1&pid=1-s2.0-S2666602224000478-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santiago Callegari , Attila Feher , Kim G. Smolderen , Carlos Mena-Hurtado , Albert J. Sinusas
{"title":"Multi-modality imaging for assessment of the microcirculation in peripheral artery disease: Bench to clinical practice","authors":"Santiago Callegari , Attila Feher , Kim G. Smolderen , Carlos Mena-Hurtado , Albert J. Sinusas","doi":"10.1016/j.ahjo.2024.100400","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100400","url":null,"abstract":"<div><p>Peripheral artery disease (PAD) is a highly prevalent disorder with a high risk of mortality and amputation despite the introduction of novel medical and procedural treatments. Microvascular disease (MVD) is common among patients with PAD, and despite the established role as a predictor of amputations and mortality, MVD is not routinely assessed as part of current standard practice. Recent pre-clinical and clinical perfusion and molecular imaging studies have confirmed the important role of MVD in the pathogenesis and outcomes of PAD. The recent advancements in the imaging of the peripheral microcirculation could lead to a better understanding of the pathophysiology of PAD, and result in improved risk stratification, and our evaluation of response to therapies. In this review, we will discuss the current understanding of the anatomy and physiology of peripheral microcirculation, and the role of imaging for assessment of perfusion in PAD, and the latest advancements in molecular imaging. By highlighting the latest advancements in multi-modality imaging of the peripheral microcirculation, we aim to underscore the most promising imaging approaches and highlight potential research opportunities, with the goal of translating these approaches for improved and personalized management of PAD in the future.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"42 ","pages":"Article 100400"},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000430/pdfft?md5=991bcea36bc203f9d052b7bc26b3e533&pid=1-s2.0-S2666602224000430-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140914330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The big problem of small vessel disease","authors":"Daniel S. Feuer , Ellen C. Keeley","doi":"10.1016/j.ahjo.2024.100398","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100398","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"42 ","pages":"Article 100398"},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000417/pdfft?md5=0820fc45a7a213b9d6d2ea5c5716c875&pid=1-s2.0-S2666602224000417-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prostate cancer and cardiovascular disease: Racial/ethnic disparities and role of chronic toxic stress/allostatic load","authors":"Harikrishnan Hyma Kunhiraman, Avirup Guha","doi":"10.1016/j.ahjo.2024.100397","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100397","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"42 ","pages":"Article 100397"},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000405/pdfft?md5=1cacd746a6a1239cb96203d60a938bf8&pid=1-s2.0-S2666602224000405-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140631661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Inmaculada Hernandez , Lanting Yang , Shangbin Tang , Teresa Cameron , Jingchuan Guo , Nico Gabriel , Utibe R. Essien , Jared W. Magnani , Walid F. Gellad
{"title":"COVID-19 pandemic and trends in clinical outcomes and medication use for patients with established atrial fibrillation: A nationwide analysis of claims data","authors":"Inmaculada Hernandez , Lanting Yang , Shangbin Tang , Teresa Cameron , Jingchuan Guo , Nico Gabriel , Utibe R. Essien , Jared W. Magnani , Walid F. Gellad","doi":"10.1016/j.ahjo.2024.100396","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100396","url":null,"abstract":"<div><h3>Study objective</h3><p>The COVID-19 pandemic disrupted multiple aspects of the health care system, including the diagnosis and control of chronic conditions. This study aimed to quantify pandemic-related changes in the rates of clinical events among patients with atrial fibrillation (AF).</p></div><div><h3>Design/setting/participants</h3><p>In this retrospective cohort study, we identified individuals with established AF at any time before 2019 using de-identified Optum's Clinformatics® Data Mart, and followed them from 3/18/2019 to death, or disenrollment, or the end of the study (09/30/2021).</p></div><div><h3>Main outcome</h3><p>Rates of clinical event, including all-cause hospitalization, ischemic stroke, and bleeding. We constructed interrupted time series to test changes in outcomes after the onset of the COVID-19 pandemic (3/11/2020, date of pandemic declaration). We then identified the first month after the start of the pandemic in which outcomes returned to pre-pandemic levels.</p></div><div><h3>Results</h3><p>A total of 561,758 patients, with a mean age of 77 ± 9.9 years, were included in the study. The monthly incidence rate of all-cause hospitalization decreased from 2.8 % in the period immediately before the pandemic declaration to 1.7 % in the period immediately after, with <em>p</em>-value for level change<0.001. The rate of new ischemic stroke diagnoses decreased from 0.28 % in the period immediately before pandemic declaration to 0.20 % in the period immediately after, and the rate of major bleeding diagnoses from 0.81 % to 0.59 %, both <em>p</em>-values for level change<0.01. The incidence rate of ischemic stroke and bleeding events returned to pre-pandemic levels in October and November 2020, respectively.</p></div><div><h3>Conclusions</h3><p>The COVID-19 pandemic was associated with a decrease in health care visits for ischemic stroke and bleeding in a nationwide cohort of patients with established AF.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"42 ","pages":"Article 100396"},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000399/pdfft?md5=3bb3bc2d04a103655eb19dc9ac4d05aa&pid=1-s2.0-S2666602224000399-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gwendolyn A. Ung , Kevin H. Nguyen , Alvin Hui , Nathan D. Wong , Elizabeth H. Dineen
{"title":"Impact of cardiorespiratory fitness and diabetes status on cardiovascular disease and all-cause mortality: An NHANES retrospective cohort study","authors":"Gwendolyn A. Ung , Kevin H. Nguyen , Alvin Hui , Nathan D. Wong , Elizabeth H. Dineen","doi":"10.1016/j.ahjo.2024.100395","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100395","url":null,"abstract":"<div><p>High cardiorespiratory fitness (CRF) is associated with decreased mortality in people with pre-diabetes (pre-DM) and diabetes mellitus (DM); however, the degree to which CRF attenuates the risk of cardiovascular disease (CVD)-related and all-cause mortality is unclear.</p></div><div><h3>Study objective</h3><p>We examined the impact of CRF status on CVD-related morbidity and all-cause mortality in non-DM, Pre-DM, and DM populations.</p></div><div><h3>Design and setting</h3><p>13,968 adults from the Third US National Health and Nutrition Examination Survey (NHANES III) were stratified into non-DM, pre-DM, or DM groups based on HbA1c levels. VO<sub>2</sub>Max was calculated using the Fitness Registry and Importance of Exercise: A National Database (FRIEND) equation.</p></div><div><h3>Participants</h3><p>Participants were categorized into tertiles of VO<sub>2</sub>Max; first VO<sub>2</sub>Max tertile was the lowest VO<sub>2</sub>Max and third VO<sub>2</sub>Max tertile was the highest.</p></div><div><h3>Main outcome measure(s)</h3><p>Cox regression was used to analyze the relationship between glycemic levels, VO<sub>2</sub>Max, and CVD-related and all-cause mortality.</p></div><div><h3>Results</h3><p>Those with DM in the highest fitness tertile had CVD (HR 0.13; 95 % CI 0.06, 0.27; <em>p</em> < 0.0001) and all cause (HR 0.28; 95 % CI 0.21, 0.38; p < 0.0001) mortality rates as low or lower than those with pre-DM (CVD HR 1.02; 95 % CI 0.78, 1.33 <em>p</em> < 0.892; all cause HR 0.96; 95 % CI 0.83, 1.12; <em>p</em> < 0.5496) or non-DM (CVD HR 0.65; 95 % CI 0.52, 0.80; <em>p</em> < 0.0001; all cause HR 0.61; 95 % CI 0.55, 0.68; p < 0.0001) at lower fitness levels. Regardless of DM status, there was lower all-cause mortality with higher CRF levels.</p></div><div><h3>Conclusions</h3><p>Higher fitness levels in DM individuals are associated with total and CVD mortality rates as low or lower than those without DM with lower fitness.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"42 ","pages":"Article 100395"},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000387/pdfft?md5=26cc953d2239907b158f54a362e30f8a&pid=1-s2.0-S2666602224000387-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shereen AlShaikh , Charlene L. Rohm , Nadia R. Sutton , Sonya N. Burgess , Mirvat Alasnag
{"title":"INOCA: Ischemia in non-obstructive coronary arteries","authors":"Shereen AlShaikh , Charlene L. Rohm , Nadia R. Sutton , Sonya N. Burgess , Mirvat Alasnag","doi":"10.1016/j.ahjo.2024.100391","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100391","url":null,"abstract":"<div><p>This article provides a summary of the clinical spectrum of no obstructive coronary arteries. We describe the pathologies, invasive and noninvasive assessment, and management strategies.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"42 ","pages":"Article 100391"},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266660222400034X/pdfft?md5=bfd9a1bec73043ac1177d7cc5d110700&pid=1-s2.0-S266660222400034X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140558731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuğçe İrgi , Ömer Faruk Baycan , Tolga Sinan Güvenç , Fatma Betül Özcan , Adem Atıcı , Yusuf Yılmaz , Mustafa Çalişkan
{"title":"Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome","authors":"Tuğçe İrgi , Ömer Faruk Baycan , Tolga Sinan Güvenç , Fatma Betül Özcan , Adem Atıcı , Yusuf Yılmaz , Mustafa Çalişkan","doi":"10.1016/j.ahjo.2024.100393","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100393","url":null,"abstract":"<div><h3>Study objectives</h3><p>Patients with carpal tunnel syndrome (CTS) show manifestations of arterial abnormalities, including carotid intimal thickening and increased vascular stiffness. As carpal tunnel syndrome is associated with amyloidosis, we hypothesized that previously observed abnormalities can largely be related with concomitant amyloidosis rather than CTS itself.</p></div><div><h3>Design</h3><p>Prospective observational study.</p></div><div><h3>Setting</h3><p>Medeniyet University Goztepe Hospital</p></div><div><h3>Participants</h3><p>61 patients with CTS (of whom 32 had biopsy-proven amyloidosis) and 36 healthy controls.</p></div><div><h3>Interventions</h3><p>Subjects underwent ultrasound examinations for the measurement of coronary flow velocity reserve (CFVR), flow-mediated vasodilatation (FMD) and carotid intimal-media thickness (CIMT).</p></div><div><h3>Main outcome measures</h3><p>Comparison of CFVR, FMD and CIMT in CTS patients with or without amyloidosis.</p></div><div><h3>Results</h3><p>Patients with either CTS or CTS with concomitant amyloidosis (CTS-A) had significantly lower FMD (9.7 % ± 4.0 % in CTS and 10.3 % ± 4.6 % in CTS-A groups, <em>p</em> < 0.05 for both) and CFVR (2.4 (2.1–2.8) in CTS and 1.8 (1.6–2.1) in CTS-A groups, <em>p</em> < 0.001 for both) as compared to controls, while CIMT was only increased in CTS-A group (0.70 (0.60–0.80), p < 0.001). The reduction in CFVR was solely related to an increased basal flow velocity in CTS patients while there was also a reduced hyperemic flow velocity in patients with CTS-A.</p></div><div><h3>Conclusion</h3><p>Most arterial phenomena in CTS patients could be attributable to concomitant amyloidosis, although endothelial dysfunction was present even in patients with CTS without amyloidosis.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"41 ","pages":"Article 100393"},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000363/pdfft?md5=c7041932eb102dbc444cea40db534979&pid=1-s2.0-S2666602224000363-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140555154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Coronary microvascular dysfunction in childhood: An emerging pathological entity and its clinical implications","authors":"Takeshi Tsuda , Gina Patel","doi":"10.1016/j.ahjo.2024.100392","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100392","url":null,"abstract":"<div><p>Coronary microvascular dysfunction (CMD) encompasses a spectrum of structural and functional alterations in coronary microvasculature resulting in impaired coronary blood flow and consequent myocardial ischemia without obstruction in epicardial coronary artery. The pathogenesis of CMD is complex involving both functional and structural alteration in the coronary microcirculation. In adults, CMD is predominantly discussed in context with anginal chest pain or existing ischemic heart disease and its risk factors. The presence of CMD suggests increased risk of adverse cardiovascular events independent of coronary atherosclerosis. Coronary microvascular dysfunction is also known in children but is rarely recognized due to paucity of concommitent coronary artery disease. Thus, its clinical presentation, underlying mechanism of impaired microcirculation, and prognostic significance are poorly understood. In this review article, we will overview variable CMD reported in children and delineate its emerging clinical significance.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"42 ","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000351/pdfft?md5=e97bd1e1b6119654589c5503bf35e4e3&pid=1-s2.0-S2666602224000351-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140622510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Rezaeian , C.L. Shufelt , J. Wei , C. Pacheco , G. Cook-Wiens , D. Berman , B. Tamarappoo , L.E. Thomson , M.D. Nelson , R.D. Anderson , J. Petersen , E.M. Handberg , C.J. Pepine , C.N. Bairey Merz
{"title":"Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study","authors":"P. Rezaeian , C.L. Shufelt , J. Wei , C. Pacheco , G. Cook-Wiens , D. Berman , B. Tamarappoo , L.E. Thomson , M.D. Nelson , R.D. Anderson , J. Petersen , E.M. Handberg , C.J. Pepine , C.N. Bairey Merz","doi":"10.1016/j.ahjo.2024.100390","DOIUrl":"https://doi.org/10.1016/j.ahjo.2024.100390","url":null,"abstract":"<div><h3>Background</h3><p>Heart failure with preserved ejection fraction (HFpEF) is the most common cardiac complication in patients with coronary microvascular dysfunction (CMD), yet its underlying pathways remain unclear. Aortic pulse-wave velocity (aPWV) is an indicator of large artery stiffness and a predictor for cardiovascular disease. However, aPWV in CMD and HFpEF is not well characterized and may provide understanding of disease progression.</p></div><div><h3>Methods</h3><p>Among participants without obstructive coronary artery disease, we evaluated 51 women with suspected CMD and 20 women and men with evidence of HFpEF. All participants underwent aPWV measurement (SphygmoCor, Atcor Medical) with higher aPWV indicating greater vascular stiffness. Cardiac magnetic resonance imaging (CMRI) assessed left ventricular (LV) ejection fraction, CMD via myocardial perfusion reserve index (MPRI), and ventricular remodeling via LV mass-volume ratio. . Statistical analysis was performed using Wilcoxon rank sum tests, Pearson correlations and linear regression analysis.</p></div><div><h3>Results</h3><p>Compared to the suspected CMD group, the HFpEF participants were older (65 ± 12 vs 56 ± 11 yrs., <em>p</em> = 0.002) had higher BMI (31.0 ± 4.3 vs 27.8 ± 6.7 kg/m<sup>2</sup>, <em>p</em> = 0.013), higher aPWV (10.5 ± 2.0 vs 8.0 ± 1.6 m/s, <em>p</em> = 0.05) and lower MPRI (1.5 ± 0.3 vs1.8 ± 0.3, <em>p</em> = 0.02), but not remodeling. In a model adjusted for cardiovascular risk factors, the HFpEF group had a lower LVEF (estimate −4.78, <em>p</em> = 0.0437) than the suspected CMD group.</p></div><div><h3>Conclusions</h3><p>HFpEF participants exhibit greater arterial stiffness and lower myocardial perfusion reserve, with lower LVEF albeit not remodeling, compared to suspected CMD participants. These findings suggest arterial stiffness may contribute to progression from CMD to HFpEF. Prospective work is needed and ongoing.</p></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"41 ","pages":"Article 100390"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666602224000338/pdfft?md5=d61c852abf291d34915320d7569ef9aa&pid=1-s2.0-S2666602224000338-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}