HFpEF Without Obesity: What Coronary Microcirculation Tells Us | JACC Baran

Host Mitsuaki Sawano, MD, welcomes Kai Nogami, MD (Mayo Clinic), to discuss his JACC Brief Report, "Higher Prevalence of Coronary Microvascular Dysfunction in Patients With HFpEF Without Obesity." Why do some patients develop HFpEF despite not being obese? In this episode, Dr. Nogami explains how combining invasive coronary function testing with exercise hemodynamics revealed a remarkably high prevalence of coronary microvascular dysfunction (CMD) in patients with non-obese HFpEF. The discussion explores why CMD may be a key driver of this distinct HFpEF phenotype, what these findings could mean for Japanese and other Asian populations, and how Mayo Clinic's unique invasive physiology platform provided new insights into HFpEF pathophysiology. Dr. Nogami also shares lessons from transforming the work into a JACC Brief Report and reflects on the enduring legacy of his mentor, the late Dr. Amir Lerman.