Vol 60, No 2 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Coronary flow reserve in hypertrophic obstructive cardiomyopathy assessed by intracoronary Doppler catheter

Jens Litmathe, Daniel Stosch, Hans Klues, Udo Boeken, Bernhard Korbmacher, Emmeran Gams
Kardiol Pol 2004;60(2):110-110.
Vol 60, No 2 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: In spite of progress in diagnosis and treatment, hypertrophic obstructive cardiomyopathy (HOCM) remains a serious medical problem. Among many issues, the pathophysiology of the coronary circulation in HOCM has not yet been fully examined.
Aim: To assess coronary flow reserve in HOCM.
Methods: The study group consisted of 15 patients (6 males, 9 females, mean age 51±15 years) with typical echocardiographic signs of HOCM and without stenosis of the coronary arteries. Using an intracoronary Doppler catheter, the average peak velocity and the absolute coronary flow reserve were determined in the proximal, medial and distal parts of the left anterior descending (LAD) and the circumflex coronary artery (Cx) following administration of papaverine, substance P, and during pacing. The coronary square plane was calculated angiographically after substance P injection. The retrograde coronary flow and the relationship between the increase of the coronary square plane and the coronary flow reserve were also examined.
Results: Under pharmacological stimulation, higher values of the average peak velocity were observed compared to pacing. A retrograde flow was observed in 8 of 10 patients in the LAD and in 3 of 8 patients in the Cx. The coronary flow reserve was higher under pharmacological stress than during pacing. No relationship was found between the increase of the coronary square plane and the coronary flow reserve.
Conclusions: No decrease in the coronary flow reserve was observed in our patients with HOCM which, however, does not exclude the possibility of ischaemia based on subordinate vessels and microcirculation changes. In the majority of patients a retrograde flow was detected.

Abstract

Background: In spite of progress in diagnosis and treatment, hypertrophic obstructive cardiomyopathy (HOCM) remains a serious medical problem. Among many issues, the pathophysiology of the coronary circulation in HOCM has not yet been fully examined.
Aim: To assess coronary flow reserve in HOCM.
Methods: The study group consisted of 15 patients (6 males, 9 females, mean age 51±15 years) with typical echocardiographic signs of HOCM and without stenosis of the coronary arteries. Using an intracoronary Doppler catheter, the average peak velocity and the absolute coronary flow reserve were determined in the proximal, medial and distal parts of the left anterior descending (LAD) and the circumflex coronary artery (Cx) following administration of papaverine, substance P, and during pacing. The coronary square plane was calculated angiographically after substance P injection. The retrograde coronary flow and the relationship between the increase of the coronary square plane and the coronary flow reserve were also examined.
Results: Under pharmacological stimulation, higher values of the average peak velocity were observed compared to pacing. A retrograde flow was observed in 8 of 10 patients in the LAD and in 3 of 8 patients in the Cx. The coronary flow reserve was higher under pharmacological stress than during pacing. No relationship was found between the increase of the coronary square plane and the coronary flow reserve.
Conclusions: No decrease in the coronary flow reserve was observed in our patients with HOCM which, however, does not exclude the possibility of ischaemia based on subordinate vessels and microcirculation changes. In the majority of patients a retrograde flow was detected.
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Keywords

hocm - coronary flow reserve - doppler catheter - coronary artery

About this article
Title

Coronary flow reserve in hypertrophic obstructive cardiomyopathy assessed by intracoronary Doppler catheter

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 60, No 2 (2004)

Pages

110-110

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2004;60(2):110-110.

Keywords

hocm - coronary flow reserve - doppler catheter - coronary artery

Authors

Jens Litmathe
Daniel Stosch
Hans Klues
Udo Boeken
Bernhard Korbmacher
Emmeran Gams

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