Peripheral Microvascular Function is Altered in Young Individuals at Risk for Hypertrophic Cardiomyopathy and Correlates with Myocardial Diastolic Function
Hypertrophic cardiomyopathy (HCM) is a major cause of sudden cardiac death in the young. Based on previous reports of functional abnormalities in not only coronary but also peripheral vessels in adults with HCM, we aimed to assess both peripheral vascular and myocardial diastolic function in young individuals with early stage of HCM and in individuals at risk for HCM. Children, adolescents and young adults (mean age 12 years) with family history of HCM who either had (HCM; n= 36), or did not have (HCM-risk; n= 30), echocardiography-documented left ventricular hypertrophy (LVH), as well as healthy matched controls (n=85) and healthy young athletes (n=12) were included in the study. All underwent assessment with 12-lead electrocardiography, 2D echocardiography, tissue Doppler (TD) imaging, and laser Doppler with transdermal iontophoresis of acetylcholine (Ach) and sodium nitroprusside (SNP). LV thickness and mass were increased in the HCM and athlete groups compared to the control and HCM-risk groups. Mitral E/eé ratio, measured via TD, was increased in the HCM (p<0.0001) and HCM-risk (p<0.01) groups compared to the control and athlete groups, as were microvascular responses to Ach (HCM, p=0.045; HCM-risk, p=0.02). The responses to Ach correlated with E/é ratio (r=0.5, p=0.001). The microvascular responses to SNP were similar in all groups (p>0.2). HCM-causing mutations or its familial history are associated with changes in the cardiac diastolic function and peripheral microvascular function even before the onset of myocardial hypertrophy. Tissue Doppler can be used to differentiate HCM from physiological LV hypertrophy in young athletes.
- Copyright © 2014, American Journal of Physiology - Heart and Circulatory Physiology
Autor / Fonte:Eva Fernlund , Todd T Schlegel , Pyotr G Platonov , Jonas Carlson , Marcus Carlsson , Petru Liuba American Journal of Physiology - Heart and Circulatory Physiology Published 20 March 2015 Vol. no. , DOI: 10.1152/ajpheart.00714.2014