title: Coronary flow reserve and diastolic dysfunction in hypertrophic cardiomyopathy.
abstract: We studied 14 patients with hypertrophic cardiomyopathy during and after atrial pacing by simultaneous registration of left ventricular high fidelity pressure measurements and M-mode echocardiography together with great cardiac vein flow measured by thermodilution. Heart rate rose from 75 +/- 18 to 142 +/- 14 beats/minute with an increase of 93 +/- 30 to 127 +/- 46 milliliters/minute of great cardiac vein flow (increase of flow/beat: 0.8 versus 1.5 milliliters/beat in normal individuals; P less than 0.05). In addition, diastolic hemodynamic parameters (such as left ventricular end-diastolic pressure, T1 (time constant of relaxation) (of first 40 milliseconds) and T2 (of second 40 milliseconds) and LVdP/dt-) changed from, respectively, 27.4 +/- 7.1 to 24.0 +/- 10.3 mm Hg; (NS), 67.3 +/- 16.1 to 65.7 +/- 22.2 liters/second; (NS) 68.6 +/- 36.9 to 52.9 +/- 19.4 (P less than 0.05), and 1592 +/- 75 to 1302 +/- 48 mm Hg/sec; P less than 0.05. Left ventricular end-diastolic dimensions decreased whereas end-diastolic wall thickness increased from, respectively, 37 +/- 3 to 34 +/- 4 millimeters; (P less than 0.05) and 14 +/- 2 to 17 +/- 1 millimeters (P less than 0.05). Eleven of the 14 patients experienced angina pectoris concomitant with ST-T depression of 1 millimeter or more on the electro-cardiogram. No correlations were found between great cardiac venous flow and hemodynamically or ultrasonically derived diastolic parameters of left ventricular function.
authors: Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
authors: F J
authors: FJ
authors: Ten Cate
authors: P W
authors: PW
authors: Serruys
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology*; D003326:Coronary Circulation; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011312:Pressure