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- W1983113346 endingPage "864" @default.
- W1983113346 startingPage "857" @default.
- W1983113346 abstract "Two distinct types of left ventricular hypertrophy (LVH) have been described: the so called physiologic hypertrophy, which is normally found in professional athletes, and pathologic LVH which is found in patients with inherited heart muscle disease such as hypertrophic cardiomyopathy (HCM) or patients with cardiac and systemic diseases characterized by pressure or volume overload. Patients with pathologic LVH have often symptoms and signs suggestive of myocardial ischemia despite normal coronary angiograms. Under these circumstances ischemia is due to coronary microvascular dysfunction (CMD). The abnormalities of the coronary microcirculation may be unrelated to the degree of LVH and cause a reduction in maximum myocardial blood flow which, in the absence of epicardial stenoses, is suggestive of CMD. There is no technique that enables direct visualization of coronary microcirculation in vivo in humans. Therefore, its assessment relies on the measurement of parameters which reflect its functional status, such as myocardial blood flow and coronary flow reserve which is an integrated measure of flow through both the large epicardial coronary arteries and the microcirculation. In this review article we discuss the pathophysiological mechanisms responsible for CMD in patients with primary and secondary LVH and how the recognition of this phenomenon is providing new important information on patient stratification and prognosis. Finally, we discuss how assessment of CMD may be used as a valuable surrogate marker to test the efficacy of old and new drugs. This article is part of a Special Issue entitled Coronary Blood Flow." @default.
- W1983113346 created "2016-06-24" @default.
- W1983113346 creator A5029153489 @default.
- W1983113346 creator A5051259646 @default.
- W1983113346 creator A5090207956 @default.
- W1983113346 date "2012-04-01" @default.
- W1983113346 modified "2023-10-02" @default.
- W1983113346 title "The coronary circulation and blood flow in left ventricular hypertrophy" @default.
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