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Coronary flow velocity reserve in hypertrophic cardiomyopathy: relation with nonuniform myocardial hypertrophy
Session:
Posters (Sessão 4 - Écran 2) - Doenças do Miocárdio e Pericárdio 1
Speaker:
Isabel Cardoso
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.3 Myocardial Disease – Diagnostic Methods
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Isabel Gonçalves Machado Cardoso; Pedro Brás; Sílvia Aguiar Rosa; Luísa Moura Branco; Ana Galrinho; António Fiarresga; Luís Rocha Lopes; Mafalda Selas; Filipa Silva; Miguel Mota Carmo; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction: </strong>Reduction in coronary flow velocity reserve (CFVR) is a recognised feature in patients with hypertrophic cardiomyopathy (HCM). We investigated the hypothesis of d<span style="color:black">iffering CFVR of coronary arteries perfusing ventricular segments with nonuniform myocardial hypertrophy, by assessing the relative CFVR</span><span style="font-family:"Arial",sans-serif"><span style="color:black">. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aims: </strong>To evaluate the impact of maximal wall thickness (MWT) in CFVR of the left anterior descendent artery (LAD), posterior descending artery (PD) and relative CFVR.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong>Sixty-seven HCM pts, prospectively seen at the outpatient cardiomyopathy clinic underwent transthoracic echocardiogram with assessment of CFVR of the LAD and of the PD by pulsed-wave Doppler, in basal conditions and during hyperaemia. Relative CFVR was calculated as the ratio between absolute CFVR of the LAD and absolute CFVR of the PD (LAD CFVR/ PD CFVR). MWT was determined in parasternal short axis views. CFVR was analysed according to the location of MWT. The relationship between these variables and CFVR was determined using Mann-Whitney U test analysis. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results: </strong>Table 1 shows the clinical and echocardiographic data of the study participants. The mean relative CFVR was 1.11 (0.34). In the segments with MWT supplied by the LAD the mean relative CFVR was 1.8 (0.53). In the segments with MWT supplied by the PD the mean relative CFVR was 1.7 (0.55). 75% of pts with segments with MWT in dependence of the PD had relative CFVR>1 and 32% with MWT supplied by the LAD had CFVR<1. There was a significant correlation between relative CFVR and the location of MWT segments (p = 0.01). In the segments with MWT supplied by the PD the CFVR of the PD is substantially lower than the CFVR of the LAD, accordingly relative CFVR was higher in pts with MWT in segments in dependence of the PD artery (p = 0.01).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion: </strong>Regional distribution of hypertrophy results in regional impairment of coronary flow. CFVR was predominantly diminished in the artery supplying the MWT segments. </span></span></p>
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