title: Myocardial blood flow and fibrosis in hypertrophic cardiomyopathy.
abstract: BACKGROUND
  We investigated the relationship between myocardial blood flow (MBF), fibrosis, risk factors for sudden death, and clinical manifestations in hypertrophic cardiomyopathy (HCM).
  
  
  RESULTS
  Sixty-two patients with HCM (45 men, overall mean age 47 ± 16 years), 15 acromegalic patients with left ventricular hypertrophy (9 man, overall mean age 47 ± 12 years), and 20 healthy subjects underwent cardiac magnetic resonance. Resting MBF was measured as the ratio between coronary sinus flow measured by phase-contrast technique and left ventricular mass. Myocardial fibrosis was evaluated by late gadolinium enhancement (LGE) technique. In HCM patients, MBF was significantly lower than in control subjects and acromegalic patients. Patients with LGE had lower MBF than those without it (0.46 ± 0.2 vs 0.66 ± 0.29 mL·min(-1)·g(-1); P < .005). Patients with ventricular tachycardia at Holter monitoring had lower MBF (0.4 ± 0.14 vs 0.6 ± 0.29 mL·min(-1)·g(-1); P < .04). Among patients with preserved systolic function, those in New York Heart Association (NYHA) functional class ≥II had lower MBF than those in NYHA functional class I (0.46 ± 0.2 vs 0.69 ± 0.3 mL·min(-1)·g(-1); P < .003). MBF was the only independent predictor of worse clinical status (NYHA ≥II; P = .01).
  
  
  CONCLUSIONS
  In HCM patients low resting MBF is associated with the presence of fibrosis. MBF is a predictor of worse clinical status.
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy. aquaro@ifc.cnr.it
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Aquaro
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Todiere
authors.forename: Andrea
authors.initials: A
authors.lastname: Barison
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Strata
authors.forename: Mario
authors.initials: M
authors.lastname: Marzilli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pingitore
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology* / Q000502:physiology; D005260:Female; D005355:Fibrosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*