Heart failure & cardiomyopathies
Apical Ischemia Is a Universal Feature of Apical Hypertrophic Cardiomyopathy
Authors' conclusion
Apical perfusion defects are universally present in ApHCM at all stages.
Study context
- Population
- Patients with apical hypertrophic cardiomyopathy (ApHCM)100 ApHCM
- Participants
- 68 / 32 / 50 / 40
- Exposure
- ApHCM vs ASH HCM vs healthy volunteers
- Overt ApHCMn = 68
- Relative ApHCMn = 32
- Asymmetrical septal hypertrophy hypertrophic cardiomyopathyn = 50
- Healthy volunteersn = 40reference
- Outcome
- Apical perfusion defects (visual and quantitative: myocardial blood flow and myocardial perfusion reserve)
Methodological details2-centre, CMR quantitative adenosine stress perfusion mapping
- 2-centre
- CMR quantitative adenosine stress perfusion mapping
Main finding
As reported in the abstract
Apical perfusion defects
Observational data: associations, not effects.
Further findings
Apical perfusion defects missed by conventional short-axis views (ApHCM)
- Patients with ApHCM whose perfusion defects were sufficiently apical that short-axis views missed them
- 10%
Stress MBF below rest values
- Stress MBF fell below rest values
- 29%
Distribution of stress MBF impairment
- Stress MBF most impaired subendocardially, with greater hypertrophy or scar, and with apical aneurysms
Predictors of impaired apical MBF
- Thicker apical segments, β-coefficient (mL/g per min), CI −0.06 to −0.01, P=0.013
- −0.031
- Higher EF, β-coefficient (mL/g per min), CI −0.04 to −0.01, P<0.005
- −0.025
- ECG maximum R-wave height, β-coefficient (mL/g per min), CI −0.04 to −0.01, P<0.005
- −0.023
Original publication
Apical Ischemia Is a Universal Feature of Apical Hypertrophic Cardiomyopathy. Circ Cardiovasc Imaging. Published 21 March 2023. doi:10.
Summarised from the published abstract; every number is checked against it