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Left ventricular outflow tract gradient is associated with reduced capillary density in hypertrophic cardiomyopathy

Ahmet Güçlü1,2, Chris Happé3,4, Seyma Eren3

  • 1Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.

European Journal of Clinical Investigation
|October 8, 2015
PubMed

Insights

Coronary microvascular dysfunction in hypertrophic cardiomyopathy (HCM) is linked to reduced capillary density. The severity of the left ventricular outflow tract (LVOT) gradient, not genetic status, correlates with this capillary reduction in HCM patients.

Area of Science:

  • Cardiovascular Research
  • Pathology
  • Microcirculation

Background:

  • Coronary microvascular dysfunction (CMD) is a key feature of hypertrophic cardiomyopathy (HCM), negatively impacting patient symptoms and prognosis.
  • Previous research suggests left ventricular outflow tract (LVOT) gradient and genetics influence CMD in HCM.
  • Reduced capillary density is a potential cause of CMD.

Purpose of the Study:

  • To investigate the relationship between capillary density and genetic status or LVOT gradient severity in HCM.
  • To determine if reduced capillary density in HCM is associated with genetic factors or the degree of LVOT obstruction.

Main Methods:

  • Immunofluorescence microscopy was used to analyze capillaries (Cap) and cardiomyocytes (CM) in septal myectomy specimens from 18 HCM patients.
  • Control myocardium was obtained from 6 individuals who died from non-cardiac causes.
  • Analysis focused on capillary density and its relation to CM area, LVOT gradient, and genetic status.

Main Results:

  • HCM patients exhibited significantly lower capillary density and fewer capillaries per cardiomyocyte area compared to controls.
  • Capillary density did not differ between genotype-negative and genotype-positive HCM patients with similar LVOT gradients.
  • A strong correlation was found between a higher LVOT gradient and reduced capillary density and capillaries per cardiomyocyte area.

Conclusions:

  • Reduced capillary density in HCM is associated with the severity of the LVOT gradient.
  • Genetic status does not appear to be the primary driver of reduced capillary density in HCM.
  • LVOT gradient severity is a significant factor in the development of coronary microvascular dysfunction in HCM.
Abstract

Keywords:
Capillary densityhypertrophic cardiomyopathyhypertrophymicrovascular dysfunction

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