Myocardial microvascular abnormalities observed by intravenous myocardial contrast echocardiography in patients with hypertrophic cardiomyopathy


      We tested the hypothesis that myocardial microvascular abnormalities occur and are influenced by clinical features in 30 patients with hypertrophic cardiomyopathy (HC) using intravenous myocardial contrast echocardiography. Patients with HC were subdivided into 3 groups: nonobstructive HC (n = 12), obstructive HC (n = 10), or HC with systolic dysfunction and heart failure (n = 8). In patients with nonobstructive HC and obstructive HC, subendocardial peak myocardial contrast intensity at the mid-septal area was significantly decreased and the transmyocardial difference of peak myocardial contrast intensity between subendocardial and periendocardial regions at the mid-septal area was significantly related to regional wall thickness. Reduced peak myocardial contrast intensities at the mid-septal subendocardial and periendocardial regions were observed in patients with HC and heart failure. Our study indicates that subendocardial microvascular abnormalities during end-systole may be associated with severity of regional myocardial hypertrophy in patients with nonobstructive HC and obstructive HC. In addition, progressive microvascular damage may occur in patients with HC and heart failure.
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        • Kaul S
        • Senior R
        • Dittrich H
        • Raval U
        • Khattar R
        • Lahiri A
        Detection of coronary artery disease with myocardial contrast echocardiography.
        Circulation. 1997; 96: 785-792
        • Richardson P
        • McKenna W
        • Bristow M
        • Maisch B
        • Mautner B
        • O'Connell J
        • Olsen E
        • Thiene G
        • Goodwin J
        • Gyarfas I
        • et al.
        Report of the 1995 World Health Organization/International Society and Federation of Cardiology task force on the definition and classification of cardiomyopathies.
        Circulation. 1996; 93: 841-842
        • Hamada M
        • Shigematsu Y
        • Ikeda S
        • Hara Y
        • Okayama H
        • Kodama K
        • Ochi T
        • Hiwada K
        Class Ia antiarrhythmic drug cibenzoline.
        Circulation. 1997; 96: 1520-1524
        • Sahn D.J
        • DeMaria A
        • Kisslo J
        • Weyman A
        Recommendations regarding quantitation in M-mode echocardiography.
        Circulation. 1978; 58: 1072-1083
        • Inoue K
        • Hamada M
        • Ohtsuka T
        • Higaki J
        Relation of myocardial blood volume to left ventricular function and future cardiac events in patients with idiopathic dilated cardiomyopathy.
        Circ J. 2004; 68: 53-58
        • Ito H
        Development of apparatus and software for myocardial contrast echocardiography (in Japanese).
        J Med Ultrasonics. 2003; 30: 511-519
        • Abe M
        • Hamada M
        • Matsuoka H
        • Shigematsu Y
        • Sumimoto T
        • Hiwada K
        Myocardial scintigraphic characteristics in patients with primary aldosteronism.
        Hypertension. 1994; 23: I-164-I-167
        • Hamada M
        • Shigematsu Y
        • Kawakami H
        • Minamino N
        • Kangawa K
        • Matsuo H
        • Hiwada K
        Increased plasma levels of adrenomedullin in patients with hypertrophic cardiomyopathy.
        Clin Sci. 1998; 94: 21-28
        • Maron B.J
        • Spirito P
        Implications of left ventricular remodeling in hypertrophic cardiomyopathy.
        Am J Cardiol. 1998; 81: 1339-1344
        • Cannon R.O
        • Dilsizian V
        • O'Gara P.T
        • Undelson J.E
        • Schenke W.H
        • Quyyumi A
        • Fananapazir L
        • Bonow R.O
        Myocardial metabolic, hemodynamic, and electrocardiographic significance of reversible thallium-201 abnormalities in hypertrophic cardiomyopathy.
        Circulation. 1991; 83: 1660-1667
        • Shimoni S
        • Frangogiannis N.G
        • Aggeli C.J
        • Shan K
        • Verani M.S
        • Quinones M.A
        • Espada R
        • Letsou G.V
        • Lawrie G.M
        • Winters W.L
        • et al.
        Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography.
        Circulation. 2003; 107: 538-544
        • Wei K
        • Ragosta M
        • Thorpe J
        • Coggins M
        • Moos S
        • Kaul S
        Noninvasive quantification of coronary blood flow reserve in humans using myocardial contrast echocardiography.
        Circulation. 2001; 103: 2560-2565