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Coronary flow reserve in hypertrophic cardiomyopathy: relation with microvascular dysfunction and pathophysiological characteristics

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Abstract

Background. The decrease in coronary flow reserve (CFR) in hypertrophic cardiomyopathy (HCM) predisposes to myocardial ischaemia, systolic dysfunction and cardiac death. In this study we investigate to which extent haemodynamic, echocardiographic, and histological parameters contribute to the reduction of CFR.

Methods. In ten HCM patients (mean age 44±14 years) and eight heart transplant (HTX) patients (mean age 51±6 years) CFR was calculated in the left anterior descending coronary artery. In all subjects haemodynamic, echocardiographic and histological parameters were assessed. The relationship between these variables and CFR was determined using linear regression analysis.

Results. CFR was reduced in HCM compared with HTX patients (1.6±0.7 vs. 2.7±0.8, p<0.01). An increase in septal thickness (p<0.005), indexed left ventricular (LV) mass (p<0.005), LV end-diastolic pressure (p<0.001), LV outflow tract gradient (p<0.05) and a decrease in arteriolar lumen size (p<0.05) were all related to a reduction in CFR.

Conclusion: In HCM patients haemodynamic (LV end-diastolic pressure, LV outflow tract gradient), echocardiographic (indexed LV mass) and histological (% luminal area of the arterioles) changes are responsible for a decrease in CFR. (Neth Heart J 2007;15:209-15.)

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    M. J. Kofflard

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  1. M. J. Kofflard
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  2. M. Michels
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  3. R. Krams
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  4. M. Kliffen
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  5. M. L. Geleijnse
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  6. F. J. Ten Cate
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  7. P. W. Serruys
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Albert Schweitzer Hospital, Dordrecht, the Netherlands

Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, the Netherlands

Department of Pathology, Erasmus Medical Centre, Rotterdam, the Netherlands

Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, the Netherlands

F.J. Ten Cate Department of Cardiology, Thoraxcentre, Room Ba 304, Erasmus Medical Centre, PO Box 2040, 3000 RA Rotterdam, the Netherlands

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Kofflard, M.J., Michels, M., Krams, R. et al. Coronary flow reserve in hypertrophic cardiomyopathy: relation with microvascular dysfunction and pathophysiological characteristics. NHJL 15, 209–215 (2007). https://doi.org/10.1007/BF03085982

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