Related Experiment Video

Updated: Aug 7, 2026

Scanning Electron Microscopy of Macerated Tissue to Visualize the Extracellular Matrix
10:21

Scanning Electron Microscopy of Macerated Tissue to Visualize the Extracellular Matrix

Published on: June 14, 2016

Coronary microvascular dysfunction and ischemia in hypertrophic cardiomyopathy. Mechanisms and clinical consequences

Iacopo Olivotto1, Franco Cecchi, Paolo G Camici

  • 1Regional Referral Center for Myocardial Diseases, Department of Cardiology, Careggi University Hospital, Florence, Italy. olivottoi@ao-careggi.toscana.it

Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
|November 24, 2004
PubMed

Insights

Patients with hypertrophic cardiomyopathy (HCM) often experience myocardial ischemia due to microvascular dysfunction, not blocked arteries. This dysfunction is a key factor in HCM complications and patient outcomes.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Medical Science

Background:

  • Hypertrophic cardiomyopathy (HCM) patients frequently exhibit symptoms of myocardial ischemia.
  • Coronary arteries in these patients are typically angiographically normal, suggesting non-obstructive causes for ischemia.
  • Myocardial ischemia contributes to severe complications in HCM, including sudden death and heart failure.

Purpose of the Study:

  • To review evidence linking microvascular dysfunction to myocardial ischemia in HCM.
  • To discuss the implications of microvascular dysfunction for HCM patient management.
  • To explore the role of microvascular dysfunction as a predictor of adverse outcomes in HCM.

Main Methods:

  • Review of studies utilizing positron emission tomography (PET) to assess myocardial perfusion.
  • Analysis of dipyridamole vasodilator response in HCM patients.
  • Correlation of microvascular dysfunction findings with autoptic evidence of coronary arteriolar abnormalities.

Main Results:

  • Positron emission tomography studies reveal impaired vasodilator response in most HCM patients.
  • This impairment affects both hypertrophied and non-hypertrophied regions of the left ventricle.
  • Findings indicate diffuse microvascular dysfunction in the absence of significant coronary artery stenoses.

Conclusions:

  • Microvascular dysfunction is a likely cause of recurrent myocardial ischemia in HCM.
  • It represents an early and significant predictor of poor prognosis in hypertrophic cardiomyopathy.
  • Understanding microvascular dysfunction is crucial for optimizing HCM management strategies.

More Related Videos

An Approach to Study Shape-Dependent Transcriptomics at a Single Cell Level06:02

An Approach to Study Shape-Dependent Transcriptomics at a Single Cell Level

Published on: November 2, 2020

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction08:35

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Published on: August 17, 2022

Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Myocarditis I: Introduction01:21

Myocarditis I: Introduction

Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...