Rush CJ, Berry C, Oldroyd KG, et al. - In hospitalized patients with heart failure with preserved ejection fraction (HFpEF), prevalence of obstructive epicardial coronary artery disease (CAD) and coronary microvascular dysfunction (CMD) is common and these conditions are often unrecognized in this population and may represent therapeutic targets.

• This prospective, multicenter, cohort study involved 106 patients hospitalized with HFpEF, evaluated via coronary angiography, invasive coronary physiologic and vasoreactivity testing, and cardiac magnetic resonance imaging.

• Among study participants, obstructive epicardial CAD was present in 51%, endothelium-independent CMD in 66%, and endothelium-dependent CMD in 24%.

• Epicardial CAD, CMD, or both was evident in 91% of patients with HFpEF.

• Among patients without obstructive CAD, presence of CMD was evident in 81%.

• More adverse events occurred during follow-up in patients with obstructive CAD vs those without obstructive CAD.