PMID- 31822572
OWN - NLM
STAT- MEDLINE
DCOM- 20210215
LR  - 20210324
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 106
IP  - 11
DP  - 2020 Jun
TI  - Inline perfusion mapping provides insights into the disease mechanism in 
      hypertrophic cardiomyopathy.
PG  - 824-829
LID - 10.1136/heartjnl-2019-315848 [doi]
AB  - OBJECTIVE: In patients with hypertrophic cardiomyopathy (HCM), the role of small 
      vessel disease and myocardial perfusion remains incompletely understood and data 
      on absolute myocardial blood flow (MBF, mL/g/min) are scarce. We measured MBF 
      using cardiovascular magnetic resonance fully quantitative perfusion mapping to 
      determine the relationship between perfusion, hypertrophy and late gadolinium 
      enhancement (LGE) in HCM. METHODS: 101 patients with HCM with unobstructed 
      epicardial coronary arteries and 30 controls (with matched cardiovascular risk 
      factors) underwent pixel-wise perfusion mapping during adenosine stress and rest. 
      Stress, rest MBF and the myocardial perfusion reserve (MPR, ratio of stress to 
      rest) were calculated globally and segmentally and then associated with segmental 
      wall thickness and LGE. RESULTS: In HCM, 79% had a perfusion defect on clinical 
      read. Stress MBF and MPR were reduced compared with controls (mean+/-SD 1.63+/-0.60 
      vs 2.30+/-0.64 mL/g/min, p<0.0001 and 2.21+/-0.87 vs 2.90+/-0.90, p=0.0003, 
      respectively). Globally, stress MBF fell with increasing indexed left ventricle 
      mass (R(2) for the model 0.186, p=0.036) and segmentally with increasing wall 
      thickness and LGE (both p<0.0001). In 21% of patients with HCM, MBF was lower 
      during stress than rest (MPR <1) in at least one myocardial segment, a phenomenon 
      which was predominantly subendocardial. Apparently normal HCM segments (normal 
      wall thickness, no LGE) had reduced stress MBF and MPR compared with controls 
      (mean+/-SD 1.88+/-0.81 mL/g/min vs 2.32+/-0.78 mL/g/min, p<0.0001). CONCLUSIONS: 
      Microvascular dysfunction is common in HCM and associated with hypertrophy and 
      LGE. Perfusion can fall during vasodilator stress and is abnormal even in 
      apparently normal myocardium suggesting it may be an early disease marker.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published 
      by BMJ.
FAU - Camaioni, Claudia
AU  - Camaioni C
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
FAU - Knott, Kristopher D
AU  - Knott KD
AUID- ORCID: 0000-0003-1611-817X
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
FAU - Augusto, Joao B
AU  - Augusto JB
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
FAU - Seraphim, Andreas
AU  - Seraphim A
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
FAU - Rosmini, Stefania
AU  - Rosmini S
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
FAU - Ricci, Fabrizio
AU  - Ricci F
AD  - University of Chieti-Pescara, Chieti, Italy.
FAU - Boubertakh, Redha
AU  - Boubertakh R
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - The William Harvey Research Institute, Queen Mary University of London, London, 
      UK.
FAU - Xue, Hui
AU  - Xue H
AD  - National Institutes of Health, Bethesda, Maryland, USA.
FAU - Hughes, Rebecca
AU  - Hughes R
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
FAU - Captur, Gaby
AU  - Captur G
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
FAU - Lopes, Luis Rocha
AU  - Lopes LR
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
FAU - Brown, Louise Anne Elizabeth
AU  - Brown LAE
AUID- ORCID: 0000-0002-1327-6482
AD  - Department of Biomedical Imaging Science, University of Leeds, Leeds, UK.
FAU - Manisty, Charlotte
AU  - Manisty C
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
FAU - Petersen, Steffen Erhard
AU  - Petersen SE
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
AD  - The William Harvey Research Institute, Queen Mary University of London, London, 
      UK.
FAU - Plein, Sven
AU  - Plein S
AD  - Department of Biomedical Imaging Science, University of Leeds, Leeds, UK.
FAU - Kellman, Peter
AU  - Kellman P
AD  - National Institutes of Health, Bethesda, Maryland, USA.
FAU - Mohiddin, Saidi A
AU  - Mohiddin SA
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK.
FAU - Moon, James C
AU  - Moon JC
AD  - Advanced Cardiac Imaging, Barts Health NHS Trust, London, UK j.moon@ucl.ac.uk.
AD  - Institute of Cardiovascular Science, University College London, London, UK.
LA  - eng
GR  - SP/20/2/34841/BHF_/British Heart Foundation/United Kingdom
GR  - DH_/Department of Health/United Kingdom
GR  - MR/T005181/1/MRC_/Medical Research Council/United Kingdom
GR  - PG/13/97/30487/BHF_/British Heart Foundation/United Kingdom
GR  - FS/18/83/34025/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191210
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Cardiomyopathy, Hypertrophic/*diagnosis/physiopathology
MH  - Coronary Circulation/*physiology
MH  - Coronary Vessels/diagnostic imaging/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Image Interpretation, Computer-Assisted
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Microcirculation/*physiology
MH  - Middle Aged
MH  - Myocardial Perfusion Imaging/*methods
MH  - Retrospective Studies
PMC - PMC7282549
OTO - NOTNLM
OT  - Advanced cardiac imaging
OT  - Cardiac magnetic resonance (CMR) imaging
OT  - Hypertrophic cardiomyopathy
COIS- Competing interests: SEP provides consultancy to Circle Cardiovascular Imaging 
      (Calgary, Alberta, Canada).
EDAT- 2019/12/12 06:00
MHDA- 2021/02/16 06:00
PMCR- 2020/06/09
CRDT- 2019/12/12 06:00
PHST- 2019/08/15 00:00 [received]
PHST- 2019/10/29 00:00 [revised]
PHST- 2019/11/05 00:00 [accepted]
PHST- 2019/12/12 06:00 [pubmed]
PHST- 2021/02/16 06:00 [medline]
PHST- 2019/12/12 06:00 [entrez]
PHST- 2020/06/09 00:00 [pmc-release]
AID - heartjnl-2019-315848 [pii]
AID - 10.1136/heartjnl-2019-315848 [doi]
PST - ppublish
SO  - Heart. 2020 Jun;106(11):824-829. doi: 10.1136/heartjnl-2019-315848. Epub 2019 Dec 
      10.