In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 96, No. 3 ( 1997-08-05), p. 834-841
Abstract:
Background In this study, we both investigated coronary flow velocity in hypertrophic obstructive cardiomyopathy (HOCM) and tested the hypothesis of differing coronary flow reserve (CFR) of coronary arteries perfusing left ventricular regions with nonuniform myocardial hypertrophy by measuring the relative CFR. Methods and Results Coronary flow velocity was assessed in left anterior descending coronary (LAD) and left circumflex (LCx) arteries in 18 patients with HOCM and marked hypertrophy only in the ventricular septum, in 13 patients without obstruction (HCM), and in 9 age- and sex-matched normal subjects at rest, during rapid atrial pacing, and after dobutamine infusion (5 to 30 μg/kg per minute). Relative CFR was estimated as the ratio between absolute CFR of the LAD and absolute CFR of the LCx (LAD/LCx CF ). At the peak of rapid atrial pacing and during dobutamine stress, LAD/LCx CF was reversed in HOCM patients (from 1.25±0.11 to 0.82±0.07 and 0.79±0.06, respectively), whereas it remained unchanged in control subjects (from 1.0±0.1 to 1.0±0.05 and 1.0±0.05, respectively; P 〈 .001). In HCM patients, LAD/LCx CF at rest was 1.10±0.11, whereas during rapid atrial pacing and dobutamine stress, it was 0.92±0.08 and 0.90±0.09, respectively. Relative CFR was 0.62±0.05 in HOCM patients and 1.05±0.05 ( P 〈 .001) in normal subjects. There was an inverse correlation between relative CFR and peak systolic outflow tract gradient ( r 2 =.74, P 〈 .001). Conclusions Regional distribution of hypertrophy in some patients with HOCM resulted in regional impairment of coronary flow. Relative CFR can be used to estimate regional disturbances of coronary flow and may help in patient selection for new interventional therapeutic techniques.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/01.CIR.96.3.834
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
1997
detail.hit.zdb_id:
1466401-X
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