title: Abnormal Myocardial Blood Flow Reserve Observed in Cardiac Amyloidosis.
abstract: We performed real-time myocardial contrast echocardiography on a patient with cardiac amyloidosis and previous normal coronary angiography presenting with atypical chest pain to assess myocardial blood flow reserve (MBFR). Myocardial contrast echocardiography was performed and flash microbubble destruction and replenishment analysis was used to calculate myocardial blood flow. Dipyridamole was used to achieve hyperemia. MBFR was derived from the ratio of peak myocardial blood flow at hyperemia and rest. The results show a marked reduction in MBFR in our patient. Previous reports of luminal obstruction of intramyocardial rather than epicardial vessels by amyloid deposition may be causing microvascular dysfunction.
authors.affiliation: Department of Cardiology, Sunshine Coast Hospital and Health Service, Nambour, QLD, Australia.
authors.forename: Michael Chi Yuan
authors.initials: MC
authors.lastname: Nam
authors.affiliation: Department of Cardiology, Sunshine Coast Hospital and Health Service, Nambour, QLD, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Nel
authors.affiliation: Department of Cardiology, Royal Brompton and Harefield NHS Trust, London, United Kingdom.
authors.forename: Roxy
authors.initials: R
authors.lastname: Senior
authors.affiliation: Department of Cardiology, Sunshine Coast Hospital and Health Service, Nambour, QLD, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Greaves
keywords: Cardiac amyloidosis; Contrast echocardiography; Echocardiography; Myocardial blood flow; Myocardial blood flow reserve