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Updated: Mar 15, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Positron-emission tomography myocardial blood flow quantification in hypertrophic cardiomyopathy
1Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy - roberto.sciagra@unifi.it.
Insights
Myocardial ischemia, driven by coronary microcirculation issues, is crucial in hypertrophic cardiomyopathy (HCM). Reduced hyperemic myocardial blood flow (hMBF) measured by PET indicates HCM severity and predicts adverse outcomes, aiding patient risk stratification.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Hypertrophic cardiomyopathy (HCM) involves complex pathophysiology where myocardial ischemia, particularly from coronary microcirculation abnormalities, plays a significant role.
- Understanding the contribution of microvascular dysfunction to HCM progression and clinical outcomes is essential for effective patient management.
Purpose of the Study:
- To investigate the role of myocardial ischemia and microvascular dysfunction in hypertrophic cardiomyopathy.
- To evaluate the utility of perfusion positron-emission tomography (PET) in assessing coronary microcirculation abnormalities and their correlation with HCM severity and prognosis.
Main Methods:
- Utilized perfusion positron-emission tomography (PET) to measure myocardial blood flow (MBF) at rest and under maximal hyperemia (hMBF).
- Correlated hMBF measurements with clinical features of HCM, including disease severity, ischemic symptoms, and myocardial fibrosis.
- Assessed the prognostic value of hMBF abnormalities in predicting adverse outcomes in HCM patients.
Main Results:
- Abnormalities in hMBF were found to be significant indicators of HCM severity.
- Reduced hMBF correlated strongly with ischemic symptoms and the presence of myocardial fibrosis.
- Severely blunted hMBF was demonstrated to be a predictor of adverse clinical outcomes in patients with HCM.
Conclusions:
- Coronary microvascular dysfunction, assessed by hMBF using PET, is a critical factor in HCM pathophysiology and clinical evolution.
- PET-derived hMBF measurements can effectively stratify patient prognosis and identify individuals at higher risk for unfavorable outcomes.
- The use of PET in selected HCM patient subsets can aid in identifying those who may benefit from closer monitoring or specific interventions.
Abstract:
In the setting of hypertrophic cardiomyopathy (HCM), ischemia plays a possibly under-evaluated role. In particular, a large body of evidence indicates that structural and functional abnormalities in the coronary microcirculation contribute to myocardial ischemia and are key elements for HCM pathophysiology and clinical evolution. Measurement of myocardial blood flow (MBF) at rest and under maximal hyperemia (hMBF) by means of perfusion positron-emission tomography (PET) is the most effective way to assess microvascular dysfunction in humans. Therefore, hMBF abnormalities reflect HCM severity and correlate with other important features, such as ischemic symptoms and myocardial fibrosis. Most importantly, it has been demonstrated that severely blunted hMBF implies an adverse outcome in HCM patients. Therefore, PET could be helpful for stratifying patient prognosis and should be used in selected patient subsets to identify those at risk of unfavorable evolution.
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