Abstract 4868: Subendmyocardial Perfusion Reserve Correlated with Left Ventricular Diastolic Function in Patients with Various Types of Left Ventricular Hypertrophy

Abstract

Reduced myocardial perfusion reserve (MPR) and left ventricular (LV) diastolic dysfunction were frequently observed in patients with LV hypertrophy (LVH). The purpose of this study was to determine the relationship between MPR assessed by stress-rest perfusion MRI and LV diastolic function in patients with various types of LVH. In patients with diastolic heart failure (DHF, n=34), hypertrophic cardiomyopathy (HCM, n=28), hypertensive LVH (n=42), cardiac amyloidosis (n=4), and control subjects (n=46), stress-rest perfusion MR images were acquired with saturation recovery balanced TFE sequence. Blood input and myocardial output curves were analyzed to determine absolute myocardial blood flow (MBF). MPR were quantified in subendocardial (subend) and subepicardial (subepi) sides of LV wall. LV diastolic function was evaluated using echocardiography, and peak early diastolic mitral annular velocity (Ea) and the ratio of peak early diastolic mitral inflow to Ea (E/Ea) were obtained. MBF at rest was 1.08 mg/ml/min and, subend and subepi MPR were 3.5 and 3.6 in control subjects. To compare with control subjects, subend MPR tended to be decreased in LVH, subend MPR was decreased in DHF, subend and subepi MPR were decreased despite preserved subend and subepi MBF in HCM, and both subend and subepi MBF as well as MPR were decreased in cardiac amyloidosis. According to the disease subgroup, Ea and subend MPR showed a significant correlation(r=0.95), and E/Ea and subend MPR showed an inversed correlation (r=−0.97). (Figure 1 ) Subend MPR significantly correlated with LV diastolic function in patients with various types of LVH.