Coronary microvascular dysfunction as assessed by multimodal diagnostic imaging in patients with hypertrophic cardiomyopathy is related to the severity of cardiac dysfunction

IF 1.9 4区医学 Q3 HEMATOLOGY Microcirculation Pub Date : 2024-01-04 DOI:10.1111/micc.12843

Tien Vuong Tran, Loic Djaileb, Laurent Riou, Lea Ruez Lantuejoul, Joris Giai, Gilles Barone-Rochette

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Abstract

Introduction

Coronary microvascular dysfunction (CMD) plays a major role in hypertrophic cardiomyopathy (HCM) physiopathology but its assessment in clinical practice remains a challenge. Nowadays, innovations in invasive and noninvasive coronary evaluation using multimodal imaging provide options for the diagnosis of CMD. The objective of the present study was to investigate if new multimodal imaging diagnosis of CMD could detect HCM patients with more impaired cardiac function by left atrioventricular coupling index (LACI).

Methods and Results

A total of 32 consecutive patients with a confirmed diagnosis of HCM (62 ± 13 years, 62% men) were prospectively screened for CMD using a multimodal imaging method. LACI was assessed by cardiovascular magnetic resonance imaging. Fifteen (47%) patients had CMD by multimodal imaging method. Patients with CMD presented a significantly higher LACI (48.5 ± 25.4 vs. 32.5 ± 10.6, p = .03). A multivariate logistic regression analysis demonstrated that CMD was independently associated with LACI (OR = 1.069, 95% CI 1.00–1.135, p = .03).

Conclusion

Multimodal imaging diagnosis of CMD is applicable to HCM patients and is associated with more impaired cardiac function.

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通过多模式诊断成像评估肥厚型心肌病患者的冠状动脉微血管功能障碍与心功能不全的严重程度有关。

导言：冠状动脉微血管功能障碍（CMD）在肥厚型心肌病（HCM）的生理病理中起着重要作用，但在临床实践中对其进行评估仍是一项挑战。如今，利用多模态成像技术进行有创和无创冠状动脉评估的创新为 CMD 的诊断提供了选择。本研究旨在探讨新的 CMD 多模态成像诊断是否能通过左房室耦合指数（LACI）发现心功能受损更严重的 HCM 患者：采用多模态成像方法对连续确诊为 HCM 的 32 名患者（62 ± 13 岁，62% 为男性）进行了 CMD 前瞻性筛查。心血管磁共振成像对 LACI 进行了评估。通过多模态成像方法，15 名（47%）患者患有 CMD。CMD患者的LACI明显更高（48.5 ± 25.4 vs. 32.5 ± 10.6，p = .03）。多变量逻辑回归分析表明，CMD与LACI独立相关（OR = 1.069，95% CI 1.00-1.135，p = .03）：结论：CMD 的多模态成像诊断适用于 HCM 患者，且与心功能受损程度更严重相关。

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.