Angiographic coronary artery disease associated with hypertensive heart failure and normal ejection fraction. Insights from a prospective monocenter study

The prevalence of underlying coronary artery disease (CAD) was examined in 23 consecutive hypertensive patients presenting with acute onset of heart failure and normal ejection fraction (HFnlEF) without clinical, electrocardiographic and biochemical evidence of myocardial ischemia. By coronary angiography, 2 patients had 1-vessel disease, 5 patients had 2-vessels disease and 1 patient had 3-vessels disease. 26% of patients was classified as having ischemic heart disease. Underlying CAD is not an uncommon finding in hypertensive HFnlEF and must be checked with the aim to enhance the therapeutic management.