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Previous observations suggest the presence of is-chemia in the disproportionately thickened interven-tricular septum (IVS) of patients with hypertrophic cardiomyopathy (HCM), although the details remain obscure. Utilizing digital subtraction coronary an-giography (DSA) with LAO projection before and after intracoronary papaverine (P) injection, we e-valuated regional myocardial coronary blood flow re-serve (rMFR) consecutively 18 patients with HCM, and compared it with that of 8 patients without apparent cardiac abnormality (C). Time-density curves were obtained from digital angiograms of the myocardial region of interest. We measured peak contrast density (Cm) and time to peak contrast(Tm). An index of rMFR was calculated as the quo-tient of Cm/Tm before and after P.

In HCM, rMFR in IVS and apex was significantly lower than that of C (Mid-IVS : 1.9± 0.5 vs 3.9±0.5, p<O.001 ; Low-IVS : 2.0±0.5 vs 4.4±0.9, p<0.001; Apex : 2.0±0.7 vs 4.5±1.6, p<O.01). There was correlation between the impairment of rMFR and the extent of hypertrophy in HCM. In conclusion, we could state that, in HCM, the region of impaired my-ocardial coronary blood flow reserve is localized. In HCM, DSA is useful in evaluating myocardial coro-nary blood flow reserve.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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