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Microcirculatory Function in Nonhypertrophic and Hypertrophic Myocardium in Patients With Aortic Valve Stenosis

BACKGROUND: Left ventricular hypertrophy (LVH) has often been supposed to be associated with abnormal myocardial blood flow and resistance. The aim of this study was to evaluate and quantify the physiological and pathological changes in myocardial blood flow and microcirculatory resistance in patien...

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Detalles Bibliográficos
Autores principales: Sabbah, Muhammad, Olsen, Niels Thue, Minkkinen, Mikko, Holmvang, Lene, Tilsted, Hans‐Henrik, Pedersen, Frants, Joshi, Francis R., Ahtarovski, Kiril, Sørensen, Rikke, Linde, Jesper James, Søndergaard, Lars, Pijls, Nico, Lønborg, Jacob, Engstrøm, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238586/
https://www.ncbi.nlm.nih.gov/pubmed/35470693
http://dx.doi.org/10.1161/JAHA.122.025381
Descripción
Sumario:BACKGROUND: Left ventricular hypertrophy (LVH) has often been supposed to be associated with abnormal myocardial blood flow and resistance. The aim of this study was to evaluate and quantify the physiological and pathological changes in myocardial blood flow and microcirculatory resistance in patients with and without LVH attributable to severe aortic stenosis. METHODS AND RESULTS: Absolute coronary blood flow and microvascular resistance were measured using a novel technique with continuous thermodilution and infusion of saline. In addition, myocardial mass was assessed with cardiac magnetic resonance imaging. Fifty‐three patients with aortic valve stenosis were enrolled in the study. In 32 patients with LVH, hyperemic blood flow per gram of tissue was significantly decreased compared with 21 patients without LVH (1.26±0.48 versus 1.66±0.65 mL·min(−1)·g(−1); P=0.018), whereas minimal resistance indexed for left ventricular mass was significantly increased in patients with LVH (63 [47–82] versus 43 [35–63] Wood Units·kg; P=0.014). CONCLUSIONS: Patients with LVH attributable to severe aortic stenosis had lower hyperemic blood flow per gram of myocardium and higher minimal myocardial resistance compared with patients without LVH.