Introduction
Hypertrophic cardiomyopathy (HCM) is often associated with ischaemia despite lack
of focal epicardial coronary stenosis. Our aim was to assess invasive coronary microvascular
circulation and correlate findings with echocardiography.
Methods
We prospectively enrolled patients with HCM and controls who were referred for diagnostic
coronary angiography. A pressure-temperature sensor coronary guidewire was used with
intracoronary injections of room-temperature saline to measure mean coronary transit
time during rest and hyperaemia induced with intravenous adenosine. The index of microvascular
resistance (IMR) was calculated. Left ventricular mass was calculated during echocardiographic
studies.
Results
Patients with HCM (n=12) and controls (n=7), had similar demographics. Left ventricular
ejection fraction was higher in HCM (76.7%±11.0% vs 55.0%±15.9%, p=0.003). IMR was
non-significantly higher in HCM (21.7±10.2 vs 15.3±4.8, p=0.16). Only patients with
HCM had abnormal IMR (>25). Coronary flow reserve was non-significantly higher in
HCM (2.7±1.6 vs 2.1±1.2, p=0.34). IMR correlated with left ventricular mass in hypertrophic
cardiomyopathy subjects (Pearson r=0.68, p=0.02).
Conclusions
Microvascular dysfunction as assessed by IMR may be abnormal in HCM and is correlated
with left ventricular mass.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart, Lung and CirculationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Review of recent advances in the management of hypertrophic cardiomyopathy.Eur Rev Med Pharmacol Sci. 2017; 21: 5207-5210
- Current perspectives in hypertrophic cardiomyopathy with the focus on patients in the Finnish population: a review.Ann Med. 2016; 48: 496-508
- Marked multi-distribution myocardial ischemia in a patient with hypertrophic cardiomyopathy and no obstructive coronary artery disease.J Nucl Cardiol. 2019; : 1-3
- Invasive assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: the index of microvascular resistance.Cardiovasc Revasc Med. 2015; 16: 426-428
- Novel index for invasively assessing the coronary microcirculation.Circulation. 2003; 107: 3129-3132
- Invasive assessment of the coronary microcirculation.Circulation. 2006; 113: 2054-2061
- Straightforward statistics for the behavioral sciences.Brooks/Cole Pub. Co, Pacific Grove1996 (600-p)
- Integrated physiologic assessment of ischemic heart disease in real-world practice using index of microcirculatory resistance and fractional flow reserve: insights from the International Index of Microcirculatory Resistance Registry.Circ Cardiovasc Interv. 2015; 8: e002857
- Quantitative assessment of coronary microvascular function in patients with and without epicardial atherosclerosis.EuroIntervention. 2010; 5: 939-945
Kofflard MJ, Michels M Fau - Krams R, Krams R Fau - Kliffen M, Kliffen M Fau - Geleijnse ML, Geleijnse Ml Fau - Ten Cate FJ, Ten Cate Fj Fau - Serruys PW, et al. Coronary flow reserve in hypertrophic cardiomyopathy: relation with microvascular dysfunction and pathophysiological characteristics. (1568-5888 (Print)).
- Determinants of coronary microvascular dysfunction in symptomatic hypertrophic cardiomyopathy.Am J Physiol Heart Circ Physiol. 2008; 294: H986-H993
- Regional difference of microcirculation in patients with asymmetric hypertrophic cardiomyopathy: transthoracic Doppler coronary flow velocity reserve analysis.J Am Soc Echocardiogr. 2013; 26: 775-782
- Link of renal microcirculatory dysfunction to increased coronary microcirculatory resistance in hypertensive patients.Cardiol J. 2017; 24: 623-632
- Invasive assessment of coronary flow reserve impairment in severe aortic stenosis and ecochadiographic correlations.Int J Cardiol. 2017; 236: 370-374
Article info
Publication history
Published online: July 28, 2021
Accepted:
July 2,
2021
Received in revised form:
April 18,
2021
Received:
October 20,
2020
Identification
Copyright
© 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
