INVESTIGATION OF MYOCARDIAL ISCHEMIA IN HYPERTROPHIC CARDIOMYOPATHY

心绞痛是一种常见的症状，在患者和在这些 无左心室流出道阻塞。 本研究 旨在研究冠状动脉血流和心肌血流动力学， 在这样的患者中。 33例HCM患者，18例无HCM 阻塞，15例左侧压差大于30 mmHg 心室流出道，进行了研究。 我们发现， 梗阻性肥厚型心肌病有较高的冠状动脉血流， 静息和起搏期间的心肌耗氧量与 无梗阻的患者，可能是由于左心室较高 收缩压和心肌氧需求。 流量较低， 在无梗阻的患者中， 峰值流量有限;这可能与左心室 微血管阻塞 不同的冠状动脉血流模式之间 有和无梗阻的患者进一步证明， 心室流出梯度产生重要的生理效应。

Angina pectoris is a common symptom in both patients with and in those without obstruction to left ventricular outflow. The present study was designed to investigate coronary flow and myocardial hemodynamics and metabolism in such patients. Thirty-three HCM patients, 18 without obstruction and 15 with a greater than 30mmHg gradient in the left ventricular outflow tract, underwent study. We found that patients with obstructive hypertrophic cardiomyopathy had higher coronary flow and myocardial oxygen consumption at rest and during pacing compared to patients without obstruction, probably due to higher left ventricular systolic pressure and myocardial oxygen requirements. Flow was lower at the on set of ischemia in patients without obstruction, suggesting more limited peak flow capacity; this possible relates to left ventricular microvascular obstruction. The different coronary flow patterns between patients with and without obstruction further demonstrate that left ventricular outflow gradients produce important physiologic effects.