Coronary flow reserve measured by stress transesophageal echocardiography in hypertrophic cardiomyopathy with subvalvular gradient

Attila Nemes, Tamás Forster, Attila Pálinkás, Márta Högye, Miklós Csanády

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Background. Coronary flow reserve (CFR) is decreased in some patients with hypertrophic cardiomyopathy (HCM) and may be determined by means of stress transesophageal echocardiography. Aim. To compare the CFR in HCM patients with or without a subvalvular gradient. Methods. Diastolic velocities were measured under baseline conditions and during maximum stress. Dipyridamole was administered as a vasodilator agent in a dose of 0.56 mg/kg over 4 minutes, and peak velocities were measured after 6 minutes. The CFR was calculated as the ratio of the peak to the baseline diastolic velocities. Nineteen HCM patients were examined together with 24 patients with normal coronary angiograms who served as controls. Results. In all HCM patients, the hypertrophy was situated in the interventricular septum (mean thickness 20.7±3.7 mm). In 6 patients, systolic anterior motion was observed, and subvalvular gradients were measured (38.7±16.3 mmHg, range 27-67 mmHg). In 3 patients no systolic velocities were detected under baseline conditions, but only during maximum stress. In another 3 patients there was a reversed systolic flow, which remained unchanged during stress. The CFR in patients with normal coronary angiograms was 3.08±1.08, while in HCM patients - 2.14±0.68 (p<0.001). The left ventricular mass was significantly higher in the HCM patients than in controls (410.7±112.8 g vs 264.6±79.4 g, p<0.05). There was a slight difference in the CFR between HCM patients with or without a subvalvular gradient (1.9±0.61 vs 2.25±0.7) but it did not reach statistical significance. Conclusions. The CFR was significantly lower in the HCM patients than in controls.

Original languageEnglish
Pages (from-to)96-100
Number of pages5
JournalKardiologia polska
Issue number8
Publication statusPublished - Aug 2002



  • Coronary flow
  • Hypertrophic cardiomyopathy
  • Transesophageal echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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