title: Invasive assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: the index of microvascular resistance.
abstract: We present a review of microvascular dysfunction in hypertrophic cardiomyopathy (HCM) and an interesting case of a symptomatic familial HCM patient with inducible ischemia by single photon emission computed tomography. Coronary angiography revealed normal epicardial arteries. Pressure wire measurements of fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microvascular resistance (IMR) demonstrated a significant microcirculatory dysfunction. This is the first such case that documents this abnormality invasively using the IMR. The measurement of IMR, a novel marker of microcirculatory dysfunction, provides novel insights into the pathophysiology of this condition.
authors.affiliation: Cardiology Department, Jerez Hospital, Jerez, Spain. Electronic address: aleklos@hotmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gutiérrez-Barrios
authors.affiliation: Cardiology Department, Punta Europa Hospital, Algeciras, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Camacho-Jurado
authors.affiliation: Cardiology Department, Jerez Hospital, Jerez, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Díaz-Retamino
authors.affiliation: Cardiology Department, Jerez Hospital, Jerez, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Gamaza-Chulián
authors.affiliation: Cardiology Department, Jerez Hospital, Jerez, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Agarrado-Luna
authors.affiliation: Cardiology Department, Jerez Hospital, Jerez, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Oneto-Otero
authors.affiliation: Cardiology Department, Jerez Hospital, Jerez, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Del Rio-Lechuga
authors.affiliation: Cardiology Department, Jerez Hospital, Jerez, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Benezet-Mazuecos
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000503:physiopathology; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D015899:Tomography, Emission-Computed, Single-Photon; D014655:Vascular Resistance
keywords: Coronary flow reserve; Hypertrophic cardiomyopathy; Index of microvascular resistance; Microvascular dysfunction