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Spatial Relationship Between Coronary Microvascular Dysfunction and Delayed Contrast Enhancement in Patients with Hypertrophic Cardiomyopathy

¹ Department of Clinical Physiopathology—Nuclear Medicine Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy; ² Regional Referral Center for Myocardial Diseases, Azienda Ospedaliera Universitaria Careggi, Florence, Italy; ³ Division of Cardiology, Ospedale Versilia, Lido di Camaiore, Italy ; ⁴ Centre for Magnetic Resonance, Azienda Ospedaliera Universitaria Careggi, Florence, Italy; and ⁵ Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, Imperial College, London, United Kingdom

View larger version (80K): [in this window] [in a new window]   FIGURE 1.  Relationship of hMBF to DCE in 28-y-old woman with HCM. (A) NH3 PET short-axis slice at level of basal LV segments. Color scale shows highest values of flow in red and lowest in green. (B) First-pass MRI short-axis slice at base of left ventricle, showing diffuse septal hypertrophy. (C) After gadolinium infusion, extensive DCE is evident (white signal), involving interventricular septum and extending into anterior wall. DCE and areas of reduced flow at PET closely agree. (D) Diagram illustrating nomenclature used for classification of myocardial segments with extent and proximity of DCE as follows: (1) transmural DCE, (2) nontransmural DCE, (3) without DCE but contiguous to DCE segments, (4) without DCE and remote from DCE. Numbers in italic indicate hMBF (mL/min/g) in segment. RV = right ventricle.

View larger version (11K): [in this window] [in a new window]   FIGURE 2.  Bar graph of hMBF in LV segments grouped according to severity and proximity of DCE, showing statistical differences according to ANOVA post hoc test.

View larger version (9K): [in this window] [in a new window]   FIGURE 3.  Bar graphs of ED wall thickness (black bars), ES wall thickness (white bars), and systolic thickening (hatched bars) in LV segments grouped according to severity and proximity of DCE, showing statistical differences according to ANOVA post hoc test.