Study design
This was a single centre, prospective cross-sectional, observational
study carried out at Poole Hospital NHS Foundation Trust, UK. The study
recruited patients between 2011-2013 aged 30-80 years who were referred
to the cardiology clinics with chest pain suggestive of myocardial
ischemia and subsequently had a diagnostic CT coronary angiography (CTA)
demonstrating no evidence of significant coronary stenosis. Exclusion
criteria were known ischemic heart disease (previous acute coronary
syndrome, previous percutaneous coronary intervention or previous
coronary artery bypass graft), valvular heart disease, LV hypertrophy or
LV ejection fraction <55%. We obtained information regarding
patient baseline demographics including age, body mass index (BMI),
hypertension, smoking status, dyslipidemia and presence or absence of
diabetes. Smoking status included both current and past smokers. Blood
samples were analyzed for fasting lipid profile (low density lipoprotein
(LDL) and triglyceride (TG)). Given the possible association between
HFpEF and inflammation,7 levels of high sensitivity
C-reactive protein (Hs-CRP), a marker of systemic inflammation, were
also measured in our patients.