Invasive assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: the index of microvascular resistance

Cardiovasc Revasc Med. 2015 Oct-Nov;16(7):426-8. doi: 10.1016/j.carrev.2015.06.008. Epub 2015 Jul 11.

Abstract

We present a review of microvascular dysfunction in hypertrophic cardiomyopathy (HCM) and an interesting case of a symptomatic familial HCM patient with inducible ischemia by single photon emission computed tomography. Coronary angiography revealed normal epicardial arteries. Pressure wire measurements of fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microvascular resistance (IMR) demonstrated a significant microcirculatory dysfunction. This is the first such case that documents this abnormality invasively using the IMR. The measurement of IMR, a novel marker of microcirculatory dysfunction, provides novel insights into the pathophysiology of this condition.

Keywords: Coronary flow reserve; Hypertrophic cardiomyopathy; Index of microvascular resistance; Microvascular dysfunction.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cardiac Catheterization*
  • Cardiomyopathy, Hypertrophic / diagnosis*
  • Cardiomyopathy, Hypertrophic / physiopathology
  • Coronary Angiography
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology*
  • Fractional Flow Reserve, Myocardial*
  • Humans
  • Male
  • Microcirculation*
  • Microvessels / diagnostic imaging
  • Microvessels / physiopathology*
  • Myocardial Perfusion Imaging / methods
  • Predictive Value of Tests
  • Tomography, Emission-Computed, Single-Photon
  • Vascular Resistance*