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Response by Taqueti and Di Carli to Letter Regarding Article, "Excess Cardiovascular Risk in Women Relative to Men Referred for Coronary Angiography Is Associated With Severely Impaired Coronary Flow Reserve, Not Obstructive Disease".

We thank Drs Zimmermann, Zelis, and van’t Veer for their interest in our article,1 in which we found that excess cardiovascular risk in women relative to men was independently associated with and mediated by impaired coronary flow reserve.

In response to their first inquiry regarding whether we examined the contribution of absolute stress flow in addition to coronary flow reserve, the answer is yes, and it was concordantly reduced (from Table 1, median [Q1–Q3] stress myocardial blood flow in mL·g–1·min–1 was 1.7 [1.2–2.3] in women and 1.5 [1.0–1.9] in men). As such, these patients have ischemic heart disease; in fact, many of them demonstrated a severe ischemic …