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Intramyocardial coronary flow characteristics in patients with hypertrophic cardiomyopathy: non-invasive assessment by transthoracic Doppler echocardiography
  1. N Watanabe,
  2. T Akasaka,
  3. Y Yamaura,
  4. M Akiyama,
  5. S Kaji,
  6. Y Saito,
  7. K Yoshida
  1. Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan
  1. Correspondence to:
    Dr Nozomi Watanabe, Department of Cardiology, Kawasaki Medical School
    577 Matsushima, Kurashiki, 701-0192, Japan; non{at}

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Inadequate coronary vasodilator reserve,1 luminal narrowing of coronary capillaries,2 and systolic compression of the intramyocardial small arteries3 are considered to contribute towards myocardial ischaemia in patients with hypertrophic cardiomyopathy (HCM). Previously, abnormal phasic coronary flow velocity pattern in the left anterior descending coronary artery (LAD) in patients with HCM, which was characterised by flow reversal in systole and slow acceleration and rapid deceleration in diastole, has been observed by Doppler guide wire method.4 However, intramyocardial coronary flow characteristics in patients with HCM have not been reported. We aimed to evaluate phasic intramyocardial coronary flow velocity pattern in patients with HCM by transthoracic Doppler echocardiography.


The study population comprised 16 consecutive patients with non-obstructive HCM (12 men, mean (SD) age 63 (16) years, range 16–79 years). The diagnosis of HCM was based on the echocardiographic demonstration of an asymmetrically hypertrophied and non-dilated left ventricle. All patients were in sinus rhythm. Patients with coronary artery disease, congestive heart failure, and diabetes mellitus were not enrolled in this study. The control subjects were 10 healthy volunteers (eight men, mean age 56 (13) years, range 35–67 years). All participants gave informed consent to the protocol approved by the committee for the protection of human subjects in research at Kawasaki Medical School.

Echocardiographic examinations were performed with an HDI-5000 …

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