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Peripheral Microvascular Function is Altered in Young Individuals at Risk for Hypertrophic Cardiomyopathy and Correlates with Myocardial Diastolic Function.

Fernlund, Eva LU ; Schlegel, Todd T; Platonov, Pyotr LU ; Carlson, Jonas LU ; Carlsson, Marcus LU and Liuba, Petru LU (2015) In American Journal of Physiology: Heart and Circulatory Physiology 308(11). p.1351-1358
Abstract
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,... (More)
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. (Less)
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Contribution to journal
publication status
published
subject
in
American Journal of Physiology: Heart and Circulatory Physiology
volume
308
issue
11
pages
1351 - 1358
publisher
American Physiological Society
external identifiers
  • pmid:25795712
  • wos:000356269600006
  • scopus:84930831722
ISSN
1522-1539
DOI
10.1152/ajpheart.00714.2014
language
English
LU publication?
yes
id
cef64e70-1d67-4a15-b905-db69ea4f03d8 (old id 5257891)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25795712?dopt=Abstract
date added to LUP
2015-04-05 13:55:58
date last changed
2017-07-02 03:00:09
@article{cef64e70-1d67-4a15-b905-db69ea4f03d8,
  abstract     = {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&lt;0.0001) and HCM-risk (p&lt;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&gt;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.},
  author       = {Fernlund, Eva and Schlegel, Todd T and Platonov, Pyotr and Carlson, Jonas and Carlsson, Marcus and Liuba, Petru},
  issn         = {1522-1539},
  language     = {eng},
  number       = {11},
  pages        = {1351--1358},
  publisher    = {American Physiological Society},
  series       = {American Journal of Physiology: Heart and Circulatory Physiology},
  title        = {Peripheral Microvascular Function is Altered in Young Individuals at Risk for Hypertrophic Cardiomyopathy and Correlates with Myocardial Diastolic Function.},
  url          = {http://dx.doi.org/10.1152/ajpheart.00714.2014},
  volume       = {308},
  year         = {2015},
}