Open AccessMicrovascular dysfunction and cardiac fibrosis in heart failure with preserved ejection fraction: a case report
Author(s) -
Narang Nikhil,
Medvedofsky Diego,
Dryer Kathryn,
Shah Sanjiv J.,
Davidson Charles J.,
Patel Amit R.,
Blair John E.A.
Publication year - 2017
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12170
Subject(s) - medicine , cardiology , heart failure , ejection fraction , pulmonary wedge pressure , heart failure with preserved ejection fraction , cardiac magnetic resonance imaging , cardiac catheterization , coronary flow reserve , cardiac index , magnetic resonance imaging , coronary artery disease , cardiac output , radiology , hemodynamics
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.