Key result
Myocardial contrast echocardiography detects impaired myocardial blood flow reserve at 1.6 in cardiac amyloidosis.
Why the study?
Microvascular dysfunction due to intramyocardial amyloid deposition causing abnormal myocardial blood flow reserve in cardiac amyloidosis was not well characterized.
Case Report (n=1)
No
Real-time myocardial contrast echocardiography demonstrated reduced myocardial blood flow reserve in a patient with cardiac amyloidosis, suggesting microvascular dysfunction.
Indicates possible microvascular dysfunction in cardiac amyloidosis; hypothesis-generating and requires larger studies before clinical adoption.
We performed real-time myocardial contrast echocardiography on a patient with cardiac amyloidosis and previous normal coronary angiography presenting with atypical chest pain to assess myocardial blood flow reserve (MBFR). Myocardial contrast echocardiography was performed and flash microbubble destruction and replenishment analysis was used to calculate myocardial blood flow. Dipyridamole was used to achieve hyperemia. MBFR was derived from the ratio of peak myocardial blood flow at hyperemia and rest. The results show a marked reduction in MBFR in our patient. Previous reports of luminal obstruction of intramyocardial rather than epicardial vessels by amyloid deposition may be causing microvascular dysfunction.
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Nam et al. (2016) conducted a case report in Cardiac amyloidosis (n=1). Cardiac amyloidosis vs. Normal healthy population was evaluated on Myocardial blood flow reserve (MBFR). A patient with cardiac amyloidosis and normal epicardial coronary arteries demonstrated a markedly reduced myocardial blood flow reserve of 1.6 (normal > 2) on myocardial contrast echocardiography.
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