Diastolic coronary vascular reserve: a new index to detect changes in the coronary microcirculation in hypertrophic cardiomyopathy
Rob Krams, MD, PhD*,*,
Folkert J. Ten Cate, MD, PhD, FACC, FESC*,
Stéphane G. Carlier, MD, PhD ,
A. F. W. van der Steen, PhD* and
Patrick W. Serruys, MD, PhD, FACC, FESC*
* Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
Cardiovascular Center, OLV Hospital, Aalst, Belgium
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Figure 1 Representative recording of the aortic and left ventricular pressure (A) and Doppler signals (B) and the construction of the pressure-velocity loop (C). Indicated in the pressure velocity loop are the calculation of conductance ( cond) and the zero pressure velocity intercept (Pzf).
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Figure 2 Aortic pressure, left ventricular pressure (A), and Doppler velocity (B) recordings from a typical hypertrophic cardiomyopathy patient plus the reconstruction of aortic pressure-Doppler velocity loops according to Mancini et al. (C).
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Figure 3 Representative recordings of the pressure-coronary velocity loops in the heart transplant recipients (HTX) (A, C) and hypertrophic cardiomyopathy patients (HCM) (B, D) during resting conditions (A, B) and after maximal hyperemia (C, D).
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Figure 4 Relative changes in both the coronary flow reserve (solid bars) and the diastolic conductance reserve (open bars). *p < 0.05 vs. control; op < 0.05 vs. hypertrophic cardiomyopathy-left circumflex coronary artery (HCM-LCx). LAD = left anterior descending coronary artery.
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Figure 5 Relation between wall thickness and coronary flow reserve (A) and diastolic coronary vascular conductance reserve (B) for all three vessel territories combined.
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