Coronary microvascular dysfunction is highly prevalent in HFpEF and correlates with systemic endothelial dysfunction and heart failure severity, highlighting it as a potential therapeutic target.
PROMIS-HFpEF is the first prospective multi-centre, multinational study to demonstrate a high prevalence of CMD in HFpEF in the absence of unrevascularized macrovascular CAD, and to show its association with systemic endothelial dysfunction (RHI, UACR) as well as markers of HF severity (NTproBNP and RV dysfunction). Microvascular dysfunction may be a promising therapeutic target in HFpEF.
Shah et al. (2018) studied this question.