The impaired flow reserve capacity of penetrating intramyocardial coronary arteries in apical hypertrophic cardiomyopathy.
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.
Youn
Ho-Joong
HJ
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
Lee
Jong-Min
JM
Park
Chul-Soo
CS
Ihm
Sang-Hyun
SH
Cho
Eun-Joo
EJ
Jung
Hae-Ok
HO
Jeon
Hui-Kyung
HK
Oh
Yong-Seog
YS
Chung
Wook-Sung
WS
Kim
Jae-Hyung
JH
Choi
Kyu-Bo
KB
Hong
Soon-Jo
SJ
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