Table 4.
Comparison of the PROMIS-HFpEF study to other published studies of coronary microvascular dysfunction in heart failure with preserved ejection fraction
| First author (year) | Sample size | Study design | Method | Major findings |
|---|---|---|---|---|
| Shah (2018) PROMIS-HFpEF | n = 202 HFpEF | Prospective, multi-centre, multi-national | Echo/Doppler CFR (CMD = CFR< 2.5) | CMD prevalence in HFpEF = 75%. CMD patients were more likely to have a history of atrial fibrillation and smoking. CFR correlated with multiple indices including UACR, NTproBNP, RHI, TAPSE, RV, LV, and LA strain |
| Dryer (2018) | n = 30 HFpEF, n = 14 controls | Prospective, two centre | Invasive coronary Doppler (CFR and IMR); CMD = CFR ≤2.0 + IMR ≥23) | CMD prevalence in HFpEF = 37% using CFR ≤2.0 + IMR ≥23; CMD prevalence in HFpEF = 47% using CFR <2.0; four-quadrant approach to defining CMD based on CFR and IMR |
| Taqueti (2017) | n = 201 without HFpEF (n = 36 with subsequent incident HFpEF) | Retrospective, single centre | Rb-82 PET (CMD = CFR <2.0) | CMD was an independent risk factor for incident HFpEF; lower CFR was associated with worse LV diastolic function |
| Srivaratharajah (2016) | n = 78 HFpEF, n = 298 non-HFpEF | Retrospective, single centre | Rb-82 PET (CMD = MFR<2.0) | CMD prevalence in HFpEF = 40%; patients with HFpEF 2.6 times more likely to have CMD than controls even after adjustment for comorbidities |
| Kato (2016) | n = 25 HFpEF, n = 13 hypertensive LVH, and n = 18 controls | Prospective, single centre | Cardiac MRI (CMD = CFR<2.5) | CMD prevalence in HFpEF = 76%; CFR was lower in HFpEF compared with hypertensive LVH and controls; CFR correlated with BNP levels |
| Sucato (2015) | n = 155 HFpEF, n = 131 non-HFpEF | Retrospective, single centre | Invasive coronary angiography (TIMI frame count and TIMI myocardial perfusion grade) | HFpEF patients had worse TIMI frame count and worse TIMI myocardial perfusion grade in all three major coronary artery territories compared to controls |
| Mohammed (2015) | n = 124 HFpEF, n = 104 controls | Retrospective, single centre | Autopsy/pathology | Compared to controls, HFpEF patients had more coronary microvascular rarefaction and myocardial fibrosis. Microvascular density was inversely associated with myocardial fibrosis |