PMID- 26066352
OWN - NLM
STAT- MEDLINE
DCOM- 20160909
LR  - 20181113
IS  - 1432-1971 (Electronic)
IS  - 0172-0643 (Print)
IS  - 0172-0643 (Linking)
VI  - 36
IP  - 8
DP  - 2015 Dec
TI  - Regional Stress-Induced Ischemia in Non-fibrotic Hypertrophied Myocardium in 
      Young HCM Patients.
PG  - 1662-9
LID - 10.1007/s00246-015-1214-5 [doi]
AB  - The relationship between hypertrophy, perfusion abnormalities and fibrosis is 
      unknown in young patients with hypertrophic cardiomyopathy (HCM). Since mounting 
      evidence suggests causal relationship between myocardial ischemia and major 
      adverse cardiac events, we sought to investigate whether (1) regional myocardial 
      perfusion is decreased in young HCM patients and in individuals at risk of HCM, 
      and (2) hypoperfused areas are larger than areas with fibrosis. HCM patients 
      (n = 12), HCM-risk subjects (n = 15) and controls (n = 9) were imaged on a 1.5 T 
      MRI scanner. Myocardial hypertrophy was assessed on cine images. Perfusion images 
      were acquired during adenosine hyperemia and at rest. Maximum upslope ratios of 
      perfusion (stress/rest) were used for semiquantitative analysis. Fibrosis was 
      assessed by late gadolinium enhancement (LGE). Results are presented as median 
      and range. Perfusion in HCM-risk subjects and in non-hypertrophied segments in 
      HCM patients showed no difference compared to controls (P = ns). Hypertrophic 
      segments in HCM patients without LGE showed decreased perfusion compared to 
      segments without hypertrophy [1.5 (1.1-2.3) vs. 2.0 (1.8-2.6), P < 0.001], and 
      hypertrophic segments with LGE showed even lower perfusion using a segmental 
      analysis [0.9 (0.6-1.8), P < 0.05]. The extent of hypoperfused myocardium in HCM 
      patients during adenosine exceeded the extent of fibrosis on LGE [20 (0-48) vs. 4 
      (0-7) % slice area, P < 0.05] and hypoperfused areas at rest (P < 0.001). 
      Regional perfusion is decreased in hypertrophied compared to non-hypertrophied 
      myocardium and is lowest in fibrotic myocardium in young HCM patients but does 
      not discriminate HCM-risk subjects from controls. The stress-induced hypoperfused 
      regions exceed regions with LGE, indicating that hypoperfusion precedes fibrosis 
      and may be a more sensitive marker of diseased myocardium in HCM.
FAU - Jablonowski, Robert
AU  - Jablonowski R
AD  - Department of Clinical Sciences, Clinical Physiology, Lund University Hospital, 
      Lund University, Lund, Sweden. robert.jablonowski@med.lu.se.
FAU - Fernlund, Eva
AU  - Fernlund E
AD  - Pediatric Heart Center, Lund University Hospital, Lund University, Lund, Sweden. 
      Eva.Fernlund@med.lu.se.
FAU - Aletras, Anthony H
AU  - Aletras AH
AD  - Department of Clinical Sciences, Clinical Physiology, Lund University Hospital, 
      Lund University, Lund, Sweden. aletras@auth.gr.
AD  - Laboratory of Medical Informatics, School of Medicine, Aristotle University of 
      Thessaloniki, Thessaloniki, Greece. aletras@auth.gr.
FAU - Engblom, Henrik
AU  - Engblom H
AD  - Department of Clinical Sciences, Clinical Physiology, Lund University Hospital, 
      Lund University, Lund, Sweden. Henrik.Engblom@med.lu.se.
FAU - Heiberg, Einar
AU  - Heiberg E
AD  - Department of Clinical Sciences, Clinical Physiology, Lund University Hospital, 
      Lund University, Lund, Sweden. Einar.Heiberg@med.lu.se.
AD  - Department of Biomedical Engineering, Faculty of Engineering, Lund University, 
      Lund, Sweden. Einar.Heiberg@med.lu.se.
AD  - Centre for Mathematical Sciences, Faculty of Engineering, Lund University, Lund, 
      Sweden. Einar.Heiberg@med.lu.se.
FAU - Liuba, Petru
AU  - Liuba P
AD  - Pediatric Heart Center, Lund University Hospital, Lund University, Lund, Sweden. 
      Petru.Liuba@med.lu.se.
FAU - Arheden, Hakan
AU  - Arheden H
AD  - Department of Clinical Sciences, Clinical Physiology, Lund University Hospital, 
      Lund University, Lund, Sweden. Hakan.Arheden@med.lu.se.
FAU - Carlsson, Marcus
AU  - Carlsson M
AD  - Department of Clinical Sciences, Clinical Physiology, Lund University Hospital, 
      Lund University, Lund, Sweden. Marcus.Carlsson@med.lu.se.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150612
PL  - United States
TA  - Pediatr Cardiol
JT  - Pediatric cardiology
JID - 8003849
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiomyopathy, Hypertrophic/*physiopathology
MH  - Case-Control Studies
MH  - Child
MH  - Contrast Media
MH  - Female
MH  - Fibrosis
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Myocardial Ischemia/*diagnosis
MH  - Myocardial Perfusion Imaging
MH  - Myocardium/*pathology
MH  - Ventricular Dysfunction, Left/*physiopathology
MH  - Young Adult
PMC - PMC4655207
OTO - NOTNLM
OT  - CMR
OT  - Fibrosis
OT  - Ischemia
OT  - Magnetic resonance imaging
OT  - Myocardial perfusion
EDAT- 2015/06/13 06:00
MHDA- 2016/09/10 06:00
PMCR- 2015/06/12
CRDT- 2015/06/13 06:00
PHST- 2015/03/06 00:00 [received]
PHST- 2015/05/21 00:00 [accepted]
PHST- 2015/06/13 06:00 [entrez]
PHST- 2015/06/13 06:00 [pubmed]
PHST- 2016/09/10 06:00 [medline]
PHST- 2015/06/12 00:00 [pmc-release]
AID - 10.1007/s00246-015-1214-5 [pii]
AID - 1214 [pii]
AID - 10.1007/s00246-015-1214-5 [doi]
PST - ppublish
SO  - Pediatr Cardiol. 2015 Dec;36(8):1662-9. doi: 10.1007/s00246-015-1214-5. Epub 2015 
      Jun 12.