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Abnormal myocardial capillary density in apical hypertrophic cardiomyopathy can be assessed by myocardial contrast echocardiography.

Authors
 Jeonggeun Moon  ;  In Jeong Cho  ;  Chi Young Shim  ;  Jong-Won Ha  ;  Yangsoo Jang  ;  Namsik Chung  ;  Se-Joong Rim 
Citation
 CIRCULATION JOURNAL, Vol.74(10) : 2166-2172, 2010 
Journal Title
 CIRCULATION JOURNAL 
ISSN
 1346-9843 
Issue Date
2010
MeSH
Aged ; Capillaries/pathology* ; Cardiomyopathy, Hypertrophic/diagnosis ; Cardiomyopathy, Hypertrophic/diagnostic imaging* ; Case-Control Studies ; Coronary Artery Disease/diagnosis ; Coronary Circulation* ; Echocardiography/methods* ; Female ; Humans ; Hypertrophy, Left Ventricular/diagnostic imaging ; Male ; Middle Aged ; Myocardial Contraction* ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon
Abstract
BACKGROUND: Myocardial ischemia and dysfunction can occur in hypertrophic cardiomyopathy (HCM) because of the high muscle-to-blood ratio, even without significant coronary artery disease. Microbubbles reside only in the intravascular space and myocardial video-intensity during systole results mostly from microbubbles within capillaries. The hypothesis explored in the present study was that an abnormal capillary density in apical HCM (ApHCM) can be demonstrated using myocardial contrast echocardiography (MCE). METHODS AND RESULTS: The 56 patients were investigated (31 males, age 58 ± 9 years; 33 ApHCM, 9 hypertensive left ventricular hypertrophy [LVH], 14 controls). MCE was performed with low-mechanical-index power modulation imaging. Tissue Doppler imaging to assess myocardial contractile function was obtained at the mitral annulus (S'), and (99 m)Tc-MIBI SPECT was also performed. All ApHCM patients exhibited perfusion defects at the hypertrophied segments in the systolic phase during MCE, whereas SPECT showed normal or rather increased perfusion at those sites. The cyclic variation of video-intensity was exaggerated in ApHCM when compared with the LVH or control group (% of [systolic video-intensity]/[diastolic video-intensity]: 33.0 ± 12.3%, 88.3 ± 19.2% and 79.4 ± 13.9%, respectively [P<0.05]). Concurrently, MCE cyclic variation and perfusion defect size were related to decreased S' (P<0.05 for all). CONCLUSIONS: A perfusion defect at the hypertrophied segment, representing abnormal myocardial capillary density, was observed in ApHCM patients during MCE. The extent of MCE cyclic variation and the perfusion defect size both correlate with decreased myocardial contractile property in ApHCM.
Files in This Item:
T201002807.pdf Download
DOI
10.1253/circj.CJ-10-0241
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Moon, Jeong Geun(문정근)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Cho, In Jeong(조인정)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101748
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