Stress Hypoperfusion and Tissue Injury in Hypertrophic Cardiomyopathy

• DOI: 10.1161/circimaging.112.000170
• Publication Date: 2013-02-15T03:28:20Z
• Authors: Chung Chun Tyan; Sarah Armstrong; David Scholl; John Stirrat; Kimberly Blackwood; Omar El-Sherif; Terry Thompson; Gerald Wisenberg; Frank S. Prato; Aaron So; Ting Yim Lee; Maria Drangova; James A. White
• Keywords: Adult; Chi-Square Distribution; Myocardium; Vasodilator Agents; Myocardial Ischemia; Myocardial Perfusion Imaging; Contrast Media; Magnetic Resonance Imaging, Cine; Stroke Volume; Cardiomyopathy, Hypertrophic; Middle Aged; Fibrosis; Ventricular Function, Left; 3. Good health; Myocarditis; 03 medical and health sciences; Phenotype; 0302 clinical medicine; Predictive Value of Tests; Coronary Circulation; Humans; Prospective Studies; Aged

Ischemia and tissue injury are common in patients with hypertrophic cardiomyopathy. Cardiovascular magnetic resonance imaging offers combined evaluations of each phenomenon at sufficiently high resolution to examine transmural spatial distribution. In this prospective cohort study, we the distribution stress perfusion abnormalities cardiomyopathy.One hundred consecutive cardiomyopathy underwent cardiovascular imaging. Cine, perfusion, late gadolinium enhancement, T2-weighted techniques were used. Each was spatially coregistered according predefined segmental subsegmental models blindly analyzed for using validated techniques. Spatial associations among T2 made levels. Of 100 studied, phenotype septal 86 apical 14. Late enhancement abnormal 79 (79%). Eighty-six met prespecified safety criteria undergo ischemia identified 46 (57%). available 81 19 (29%). The dominant all 3 findings segment hypertrophy. Subsegmental analysis revealed geographic dominance within subendocardial zones. However, zone most commonly spared from abnormalities, typically seen midwall subepicardial zones.Inducible hypoperfusion is a finding segments exhibiting markers injury. respective these phenomena seems distinct. Alternate factors contributing regional susceptibility deserving further study.