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Exploring the nexus between myocardial microcirculation perfusion and contractile mechanics in nonobstructive

Jing Nan1,2, Lina Guan1,2, Chao Yuan3

  • 1Department of Cardiac Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.

Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research
|June 24, 2025
PubMed

Insights

Myocardial microcirculation perfusion and global longitudinal strain (GLS) are impaired in nonobstructive hypertrophic cardiomyopathy (HCM) patients. Damage is more pronounced in hypertrophic segments, linked to altered mechanical properties.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Hypertrophic cardiomyopathy (HCM) can present without obstructive features.
  • Understanding microcirculation and mechanical properties in nonobstructive HCM is crucial for patient management.
  • Previous studies have not fully elucidated the interplay between perfusion and mechanics in this specific HCM subtype.

Purpose of the Study:

  • To quantitatively analyze myocardial microcirculation perfusion in nonobstructive HCM patients.
  • To evaluate the mechanical properties of the myocardium in nonobstructive HCM.
  • To investigate the correlation between perfusion and mechanical characteristics in hypertrophic segments.

Main Methods:

  • Study included 28 nonobstructive HCM patients and 28 healthy controls.
  • Utilized two-dimensional echocardiography, contrast-enhanced myocardial ultrasound (MCE), and 2D speckle tracking imaging.
  • Classified nonobstructive HCM patients into hypertrophic segmental (HS) and non-hypertrophic segmental myocardium groups.

Main Results:

  • No significant demographic differences between HCM and control groups.
  • Significant disparities in myocardial perfusion and mechanical properties observed in nonobstructive HCM.
  • Global longitudinal strain (GLS) was significantly decreased in nonobstructive HCM patients; HS showed a positive correlation between perfusion and mechanical parameters.

Conclusions:

  • Myocardial microcirculation perfusion and GLS are impaired in nonobstructive HCM.
  • Hypertrophic segments (HS) exhibit more pronounced damage, closely associated with altered myocardial mechanical characteristics.
  • These findings highlight the importance of assessing both perfusion and mechanics in nonobstructive HCM.

Keywords:
Nonobstructive hypertrophic cardiomyopathycontrast-enhanced myocardial ultrasoundmyocardial mechanical propertiesmyocardial perfusiontwo-dimensional echocardiographytwo-dimensional speckle tracking imaging

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