Relationship between atrial fibrillation and blunted hyperemic myocardial blood flow in patients with hypertrophic cardiomyopathy

Roberto Sciagrà, Barbara Sotgia, Iacopo Olivotto, Franco Cecchi, Stefano Nistri, Paolo G. Camici, Alberto Pupi

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Atrial fibrillation (AF) and coronary microvascular dysfunction (CMD) are common in hypertrophic cardiomyopathy (HCM), but whether they are associated is unclear. We assessed the relationship between AF and CMD in HCM. Methods and Results: Global hyperemic myocardial blood flow (hMBF) was measured in 95 HCM patients (16 with, 79 without paroxysmal or chronic AF) by N-13 ammonia positron emission tomography (PET) after dipyridamole infusion. AF patients were older (50.5 ± 13.4 vs. 38.7 ± 14.9 years, P <.0005), had larger left atrial diameter (49.8 ± 7.4 vs 38.6 ± 5.7 mm, P <.00001), and left ventricular end-systolic diameter (30.4 ± 6.7 vs 25.5 ± 5.3 mm, P <.005) compared with those in stable sinus rhythm. In patients with AF, hMBF was significantly lower (1.23 ± 0.44 vs 1.87 ± 0.90 mL/min/g, P <0.0001). In multivariate logistic regression analysis, hMBF, left atrial diameter, and age were independently associated with AF (P <.05 for all). Conclusions: HCM patients with paroxysmal or chronic AF have lower hMBF than those in stable sinus rhythm. The association between CMD and AF is independent of other known predictors of AF, suggesting a causal link between these two features.

Original languageEnglish
Pages (from-to)92-96
Number of pages5
JournalJournal of Nuclear Cardiology
Volume16
Issue number1
DOIs
Publication statusPublished - 2009

Fingerprint

Hypertrophic Cardiomyopathy
Atrial Fibrillation
Dipyridamole
Ammonia
Positron-Emission Tomography
Logistic Models
Regression Analysis

Keywords

  • Atrial fibrillation
  • Coronary blood flow
  • Dipyridamole
  • Hypertrophic cardiomyopathy
  • Myocardial perfusion imaging
  • PET

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Relationship between atrial fibrillation and blunted hyperemic myocardial blood flow in patients with hypertrophic cardiomyopathy. / Sciagrà, Roberto; Sotgia, Barbara; Olivotto, Iacopo; Cecchi, Franco; Nistri, Stefano; Camici, Paolo G.; Pupi, Alberto.

In: Journal of Nuclear Cardiology, Vol. 16, No. 1, 2009, p. 92-96.

Research output: Contribution to journalArticle

Sciagrà, Roberto ; Sotgia, Barbara ; Olivotto, Iacopo ; Cecchi, Franco ; Nistri, Stefano ; Camici, Paolo G. ; Pupi, Alberto. / Relationship between atrial fibrillation and blunted hyperemic myocardial blood flow in patients with hypertrophic cardiomyopathy. In: Journal of Nuclear Cardiology. 2009 ; Vol. 16, No. 1. pp. 92-96.
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AU - Camici, Paolo G.

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N2 - Background: Atrial fibrillation (AF) and coronary microvascular dysfunction (CMD) are common in hypertrophic cardiomyopathy (HCM), but whether they are associated is unclear. We assessed the relationship between AF and CMD in HCM. Methods and Results: Global hyperemic myocardial blood flow (hMBF) was measured in 95 HCM patients (16 with, 79 without paroxysmal or chronic AF) by N-13 ammonia positron emission tomography (PET) after dipyridamole infusion. AF patients were older (50.5 ± 13.4 vs. 38.7 ± 14.9 years, P <.0005), had larger left atrial diameter (49.8 ± 7.4 vs 38.6 ± 5.7 mm, P <.00001), and left ventricular end-systolic diameter (30.4 ± 6.7 vs 25.5 ± 5.3 mm, P <.005) compared with those in stable sinus rhythm. In patients with AF, hMBF was significantly lower (1.23 ± 0.44 vs 1.87 ± 0.90 mL/min/g, P <0.0001). In multivariate logistic regression analysis, hMBF, left atrial diameter, and age were independently associated with AF (P <.05 for all). Conclusions: HCM patients with paroxysmal or chronic AF have lower hMBF than those in stable sinus rhythm. The association between CMD and AF is independent of other known predictors of AF, suggesting a causal link between these two features.

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