PMID- 29197461
OWN - NLM
STAT- MEDLINE
DCOM- 20180719
LR  - 20180719
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 251
DP  - 2018 Jan 15
TI  - Ineffective and prolonged apical contraction is associated with chest pain and 
      ischaemia in apical hypertrophic cardiomyopathy.
PG  - 65-70
LID - S0167-5273(17)30768-4 [pii]
LID - 10.1016/j.ijcard.2017.09.206 [doi]
AB  - OBJECTIVES: To investigate the hypothesis that persistence of apical contraction 
      into diastole is linked to reduced myocardial perfusion and chest pain. 
      BACKGROUND: 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. METHODS: 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). RESULTS: 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). CONCLUSION: 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.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Stephenson, Edward
AU  - Stephenson E
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom.
FAU - Monney, Pierre
AU  - Monney P
AD  - Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom; University 
      Hospital of Lausanne (CHUV), Lausanne, Switzerland.
FAU - Pugliese, Francesca
AU  - Pugliese F
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom; Barts Heart 
      Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Malcolmson, James
AU  - Malcolmson J
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom; Barts Heart 
      Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Petersen, Steffen E
AU  - Petersen SE
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom; Barts Heart 
      Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Knight, Charles
AU  - Knight C
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom; Barts Heart 
      Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Mills, Peter
AU  - Mills P
AD  - Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Wragg, Andrew
AU  - Wragg A
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom; Barts Heart 
      Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - O'Mahony, Constantinos
AU  - O'Mahony C
AD  - Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Sekhri, Neha
AU  - Sekhri N
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom; Barts Heart 
      Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Mohiddin, Saidi A
AU  - Mohiddin SA
AD  - William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Centre 
      at Barts, Queen Mary University of London, London, United Kingdom; Barts Heart 
      Centre, Barts Health NHS Trust, London, United Kingdom. Electronic address: 
      saidi.mohiddin@bartshealth.nhs.uk.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
CIN - Int J Cardiol. 2018 Jan 15;251:71-73. PMID: 29197462
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/*physiopathology
MH  - Chest Pain/diagnostic imaging/*physiopathology
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction/*physiology
MH  - Myocardial Ischemia/diagnostic imaging/*physiopathology
MH  - Retrospective Studies
MH  - Time Factors
OTO - NOTNLM
OT  - CMR
OT  - Cardiac magnetic resonance
OT  - Hypertrophic cardiomyopathy
OT  - Perfusion
EDAT- 2017/12/05 06:00
MHDA- 2018/07/20 06:00
CRDT- 2017/12/04 06:00
PHST- 2017/05/15 00:00 [received]
PHST- 2017/09/07 00:00 [revised]
PHST- 2017/09/25 00:00 [accepted]
PHST- 2017/12/04 06:00 [entrez]
PHST- 2017/12/05 06:00 [pubmed]
PHST- 2018/07/20 06:00 [medline]
AID - S0167-5273(17)30768-4 [pii]
AID - 10.1016/j.ijcard.2017.09.206 [doi]
PST - ppublish
SO  - Int J Cardiol. 2018 Jan 15;251:65-70. doi: 10.1016/j.ijcard.2017.09.206.