| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2004;128:163-169
© 2004 The American Association for Thoracic Surgery
Cardiopulmonary support and physiology |
a Department of Cardiology, University Hospital, Zürich, Switzerland
b Department of Nuclear Cardiology, University Hospital, Zürich, Switzerland
c Department of Cardiothoracic Surgery, University Hospital, Zürich, Switzerland
d Department of Cardiology, Swiss Heart Center, Berne, Switzerland
Received for publication April 21, 2003; revisions received July 12, 2003; accepted for publication November 4, 2003.
* Address for reprints: Philipp Kaufmann, MD, Head, Nuclear Cardiology, Cardiovascular Center, University Hospital C NUK 32, Rämistr. 100, CH—8091 Zürich, Switzerland
pak{at}usz.ch
OBJECTIVE: Chest pain is a common finding in patients with hypertrophic cardiomyopathy and can be observed in 40% to 50% of all patients. However, the pathogenesis of these ischemia-like symptoms is still unclear.
METHODS: Twenty-two patients with hypertrophic cardiomyopathy and 15 controls underwent positron emission tomography for evaluation of regional myocardial perfusion and coronary flow reserve (hyperemic/baseline myocardial blood flow). Myocardial perfusion (mL/min/g) was measured using [13N]ammonia at rest and during hyperemia with dipyridamole (0.56 mg/kg intravenously). Regional coronary flow reserve was assessed in 3 planes (apical, midventricular, basal) in 4 regions (septal, anterior, lateral, inferior). Patients were divided into 2 groups: group 1 consisted of 11 patients treated with surgical myectomy (age 56 ± 10 years) and group 2 consisted of 11 patients treated medically (age 53 ± 13 years).
RESULTS: Mean global coronary flow reserve was 3.87 ± 0.92 in controls but 2.31 ± 0.40 in operated (P < .001 vs controls) and 1.76 ± 0.58 in medically treated patients (P < .001 vs controls, P < .05 vs operated). Similarly, septal coronary flow reserve was 4.19 ± 1.22 in controls but significantly reduced in operated patients (2.26 ± 0.48, P < .001 vs controls) and in medically treated patients (1.76 ± 0.58; P < .001 vs controls). However, septal flow reserve was significantly higher in operated patients than in patients with medically treated hypertrophic cardiomyopathy (+37%, P < .05), mainly due to a reduced resting myocardial perfusion.
CONCLUSIONS: Global and regional myocardial perfusion is reduced in patients with hypertrophic cardiomyopathy. However, myectomy may have a beneficial effect on septal perfusion and flow reserve. Thus, ischemia seems to play an important role in the symptomatology and pathophysiology of hypertrophic cardiomyopathy.
This article has been cited by other articles:
|
|
 |
|
  B. A. Herzog, L. Husmann, I. Valenta, O. Gaemperli, P. T. Siegrist, F. M. Tay, N. Burkhard, C. A. Wyss, and P. A. Kaufmann Long-Term Prognostic Value of (13)N-Ammonia Myocardial Perfusion Positron Emission Tomography Added Value of Coronary Flow Reserve. J. Am. Coll. Cardiol., July 7, 2009; 54(2): 150 - 156. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Knaapen, T. Germans, P. G. Camici, O. E. Rimoldi, F. J. ten Cate, J. M. ten Berg, P. A. Dijkmans, R. Boellaard, W. G. van Dockum, M. J. W. Gotte, et al. Determinants of coronary microvascular dysfunction in symptomatic hypertrophic cardiomyopathy Am J Physiol Heart Circ Physiol, February 1, 2008; 294(2): H986 - H993. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Kaufmann and P. G. Camici Myocardial Blood Flow Measurement by PET: Technical Aspects and Clinical Applications J. Nucl. Med., January 1, 2005; 46(1): 75 - 88. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
