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[Myocardial ischemia in patients with hypertrophic cardiomyopathy]

N G Poteshkina1,2, E A Kovalevskaya3, N S Krylova1,2

  • 1Pirogov Russian National Research Medical University, 117997, Moscow.

Problemy Sotsial'Noi Gigieny, Zdravookhraneniia I Istorii Meditsiny
|November 21, 2019
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) patients with myocardial ischemia often have coronary artery disease (CAD). Key risk factors include age, family history, and hypertension, with distinct cardiac structural differences observed.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex condition often associated with myocardial ischemia.
  • Understanding the interplay between HCM, myocardial ischemia, and coronary artery disease (CAD) is crucial for patient management.

Purpose of the Study:

  • To comprehensively evaluate clinical and instrumental findings in patients with HCM and myocardial ischemia.
  • To identify risk factors for CAD in HCM patients and characterize differences in those with and without concomitant CAD.

Main Methods:

  • Clinical evaluation of 104 HCM patients, including risk factor assessment, ECG, echocardiography, stress ECG, and 24-hour ECG monitoring.
  • Coronary angiography (CAG) and MSCT of coronary arteries performed in cases of suspected ischemia.
  • Patients divided into groups based on the presence of myocardial ischemia and coronary atherosclerosis.

Main Results:

  • Significant risk factors for CAD in HCM patients include age, family history, elevated systolic/diastolic blood pressure, and long-term hypertension.
  • HCM patients with myocardial ischemia and without CAD showed smaller left anterior descending artery (LAD) diameter, higher left ventricular (LV) mass index, and greater LV diastolic dysfunction.
  • Decreased myocardial perfusion was linked to high LV mass index and cardiac arrhythmias.

Conclusions:

  • Age, family history, and hypertension are significant risk factors for CAD in HCM patients.
  • Distinct echocardiographic findings characterize HCM patients with myocardial ischemia, particularly those without obstructive CAD.
  • A substantial proportion (41.4%) of HCM patients with myocardial ischemia also have coronary atherosclerosis.

Keywords:
LV hypertrophycoronary artery diseasecoronary atherosclerosishypertrophic cardiomyopathymyocardial ischemia

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