Abstract 18242: Maladaptive Remodeling in Women with Signs and Symptoms of Ischemia and Elevated Left Ventricular End-diastolic Pressure

Background: Women with signs and symptoms of ischemia but no obstructive coronary artery disease (CAD) often have elevated left ventricular end-diastolic pressure (LVEDP). We have previously demonstrated that this is linked with coronary microvascular dysfunction (CMD). However, elevated LVEDP in the absence of CMD has not been well examined. Methods: 182 women with signs and symptoms of ischemia and no obstructive CAD underwent invasive coronary reactivity testing (CRT), LVEDP measurement at rest, and rest cardiac magnetic resonance imaging (CMRI, 1.5 T). CMD was assessed using a Doppler wire in the left anterior descending artery and intracoronary injections of adenosine and acetylcholine. Overall, 35/182 (19%) women had no evidence of CMD, with coronary flow reserve ≥ 2.5, coronary blood flow response ≥ 50%, and acetylcholine diameter response > 0%. CMRI measured LV size, mass and function. Two-sample T test and Fisher Exact Test were used for statistical analysis. Results: Of the 35 women without CMD,...