Ineffective and prolonged apical contraction is associated with chest pain and ischaemia in apical hypertrophic cardiomyopathy.

Détails

ID Serval
serval:BIB_6D02232AEFB8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Ineffective and prolonged apical contraction is associated with chest pain and ischaemia in apical hypertrophic cardiomyopathy.
Périodique
International journal of cardiology
Auteur(s)
Stephenson E., Monney P., Pugliese F., Malcolmson J., Petersen S.E., Knight C., Mills P., Wragg A., O'Mahony C., Sekhri N., Mohiddin S.A.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Statut éditorial
Publié
Date de publication
15/01/2018
Peer-reviewed
Oui
Volume
251
Pages
65-70
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Résumé
To investigate the hypothesis that persistence of apical contraction into diastole is linked to reduced myocardial perfusion and chest pain.
Apical hypertrophic cardiomyopathy (HCM) is defined by left ventricular (LV) hypertrophy predominantly of the apex. Hyperdynamic contractility resulting in obliteration of the apical cavity is often present. Apical HCM can lead to drug-refractory chest pain.
We retrospectively studied 126 subjects; 76 with apical HCM and 50 controls (31 with asymmetrical septal hypertrophy (ASH) and 19 with non-cardiac chest pain and culprit free angiograms and structurally normal hearts). Perfusion cardiac magnetic resonance imaging (CMR) scans were assessed for myocardial perfusion reserve index (MPRi), late gadolinium enhancement (LGE), LV volumes (muscle and cavity) and regional contractile persistence (apex, mid and basal LV).
In apical HCM, apical MPRi was lower than in normal and ASH controls (p<0.05). In apical HCM, duration of contractile persistence was associated with lower MPRi (p<0.01) and chest pain (p<0.05). In multivariate regression, contractile persistence was independently associated with chest pain (p<0.01) and reduced MPRi (p<0.001).
In apical HCM, regional contractile persistence is associated with impaired myocardial perfusion and chest pain. As apical myocardium makes limited contributions to stroke volume, apical contractility is also largely ineffective. Interventions to reduce apical contraction and/or muscle mass are potential therapies for improving symptoms without reducing cardiac output.
Mots-clé
Adult, Aged, Cardiomyopathy, Hypertrophic/diagnostic imaging, Cardiomyopathy, Hypertrophic/physiopathology, Chest Pain/diagnostic imaging, Chest Pain/physiopathology, Cohort Studies, Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging, Cine/methods, Male, Middle Aged, Myocardial Contraction/physiology, Myocardial Ischemia/diagnostic imaging, Myocardial Ischemia/physiopathology, Retrospective Studies, Time Factors, CMR, Cardiac magnetic resonance, Hypertrophic cardiomyopathy, Perfusion
Pubmed
Web of science
Création de la notice
07/12/2017 21:42
Dernière modification de la notice
20/08/2019 15:26
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