Heart Failure and Cardiomyopathies

A820JACC April 1, 2014

Volume 63, Issue 12

peripheral MicrovaScular function iS altered in young individualS at riSk for hypertrophic cardioMyopathy and correlateS with diaStolic Myocardial function

Poster ContributionsHall CSaturday, March 29, 2014, 3:45 p.m.-4:30 p.m.

Session Title: Heart Failure and Cardiomyopathies: Diagnostic, Prognostic and Therapeutic Strategies in CardiomyopathiesAbstract Category: 12. Heart Failure and Cardiomyopathies: ClinicalPresentation Number: 1147-174

Authors: Eva Fernlund, Todd Schlegel, Pyotr G. Platonov, Marcus Carlsson, Jonas Carlson, Petru Liuba, Pediatric Cardiology, Lund, Sweden, Cardiology, and Clinical Physiology, Lund, Sweden

aims: Hypertrophic cardiomyopathy (HCM) is the main cause of sudden cardiac death in the young. Adult patients with HCM appear to have functional abnormalities in the coronary circulation and also in the peripheral vessels. The aim of present study was to assess peripheral vascular function and myocardial diastolic function in young individuals with familial HCM or at risk for developing this disease.

Methods: Children, adolescents and young adults (mean 13,6 years) with heredity for familial HCM, either with left ventricular hypertrophy (HCM; n=10) or without (HCM-risk; n=10), age and gender matched healthy controls (n=20) were included. Young athletes were studied as well. All underwent assessment with 12-lead electrocardiography, 2D echocardiography, and tissue Doppler imaging (TDI). Skin microvascular responses to acetylcholine (Ach) and sodium nitroprusside were measured via laser Doppler.

results: Left ventricular thickness and mass did not differ between controls and HCM risk individuals (p>0.4), but were increased in the HCM group. Left ventricular diastolic function measured as E/e´ ratio was increased in HCM (p<0.0001) and HCM-risk (p=0.05) groups versus control and athlete groups (p=0.18). Microvascular responses to Ach were increased in both the HCM (p=0.045) and HCM-risk groups (p=0.011), whereas no difference was observed between controls and athletes (p=0.9). The responses to Ach correlated with E/é ratio (p=0.0002).

conclusion: Compared to controls, enhanced microvascular responses of peripheral circulation, are present in both young presymptomatic HCM-risk and HCM patients. These microvascular changes are associated with abnormalities in diastolic myocardial function.