title: The impaired flow reserve capacity of penetrating intramyocardial coronary arteries in apical hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Coronary flow reserve (CFR) capacity of penetrating intramyocardial coronary artery (PICA) in apical hypertrophic (AH) cardiomyopathy has not been studied yet.
  
  
  METHODS
  We studied 65 patients with normal coronary angiogram results (mean age 56 +/- 10 years; 33 men, 32 women). Of these, 30 were normotensive without any left ventricular hypertrophy (control group), 24 had hypertension (HTN) without any left ventricular hypertrophy (HTN group), and 11 had AH cardiomyopathy (AH group). PICA-CFR and PICA-width ratio were calculated after the intravenous infusion of adenosine (140 microg/kg/min) just beneath the apical impulse window at a depth of 3 to 5 cm by using high-frequency transthoracic Doppler echocardiography.
  
  
  RESULTS
  PICA-CFR was successfully measured in 59 (90.8%) of 65 patients. PICA-CFR was 1.65 +/- 0.49 in AH group, 2.50 +/- 0.77 in HTN group, and 2.42 +/- 0.73 in control group ( P < .005 vs HTN and control). PICA-width ratio was 1.45 +/- 0.42 in AH group, 2.14 +/- 0.72 in HTN group, and 1.81 +/- 0.55 in control group ( P = .025 vs HTN and control). PICA-CFR was closely related to width-ratio of PICA ( r = 0.448, P = .002). Conclusion PICA in AH has higher resting diastolic velocity, wider diameter, and impaired CFR compared with nonhypertrophied myocardium.
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, No. 62 Yoido-dong, Young-dungpo-ku, St. Mary's Hospital, Seoul 150-713, Korea. younhj@catholic.ac.kr
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Youn
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Chul-Soo
authors.initials: CS
authors.lastname: Park
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Ihm
authors.forename: Eun-Joo
authors.initials: EJ
authors.lastname: Cho
authors.forename: Hae-Ok
authors.initials: HO
authors.lastname: Jung
authors.forename: Hui-Kyung
authors.initials: HK
authors.lastname: Jeon
authors.forename: Yong-Seog
authors.initials: YS
authors.lastname: Oh
authors.forename: Wook-Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Jae-Hyung
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Choi
authors.forename: Soon-Jo
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017023:Coronary Angiography; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000473:pathology; D015588:Observer Variation; D011446:Prospective Studies