title: Myocardial microvascular abnormalities observed by intravenous myocardial contrast echocardiography in patients with hypertrophic cardiomyopathy.
abstract: We tested the hypothesis that myocardial microvascular abnormalities occur and are influenced by clinical features in 30 patients with hypertrophic cardiomyopathy (HC) using intravenous myocardial contrast echocardiography. Patients with HC were subdivided into 3 groups: nonobstructive HC (n = 12), obstructive HC (n = 10), or HC with systolic dysfunction and heart failure (n = 8). In patients with nonobstructive HC and obstructive HC, subendocardial peak myocardial contrast intensity at the mid-septal area was significantly decreased and the transmyocardial difference of peak myocardial contrast intensity between subendocardial and periendocardial regions at the mid-septal area was significantly related to regional wall thickness. Reduced peak myocardial contrast intensities at the mid-septal subendocardial and periendocardial regions were observed in patients with HC and heart failure. Our study indicates that subendocardial microvascular abnormalities during end-systole may be associated with severity of regional myocardial hypertrophy in patients with nonobstructive HC and obstructive HC. In addition, progressive microvascular damage may occur in patients with HC and heart failure.
authors.affiliation: Second Department of Internal Medicine, Ehime University School of Medicine, Ehime, Japan. katsuji@m.ehime-u.ac.jp
authors.forename: Katsuji
authors.initials: K
authors.lastname: Inoue
authors.forename: Mareomi
authors.initials: M
authors.lastname: Hamada
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakata
authors.forename: Jitsuo
authors.initials: J
authors.lastname: Higaki
mesh_terms: D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000502:physiology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008833:Microcirculation / Q000000981:diagnostic imaging / Q000502:physiology; D008875:Middle Aged; D012039:Regional Blood Flow; D012720:Severity of Illness Index