Myocardial blood flow in patients with hypertrophic cardiomyopathy receiving perindopril (CARAPaCE): a pilot study.
J Cardiovasc Med (Hagerstown)
; 22(6): 511-513, 2021 06 01.
Article
em En
| MEDLINE
| ID: mdl-33186235
ABSTRACT
AIMS:
Coronary microvascular dysfunction (CMD) represents a powerful independent predictor of adverse outcome in hypertrophic cardiomyopathy (HCM). No treatment for CMD exists. The angiotensin-converting enzyme (ACE)-inhibitor perindopril improves myocardial blood flow (MBF) in animal models of cardiac hypertrophy and in hypertensive patients. Whether HCM patients with CMD may benefit is unknown.METHODS:
Fourteen HCM patients aged 18-60 years with CMD [MBF post 0.56âmg/kg dipyridamole (Dip) infusion <2.1âml/min∗g] were included. Presence of left ventricular outflow obstruction, hypertension and coronary artery disease were exclusion criteria. Perindopril was administered after the initial Dip 13N-NH3 PET study at 10âmg for 6 months. After wash-out, a second PET was performed. MBF before and after treatment was compared.RESULTS:
No relevant associations were found between baseline MBF values and sex, genetics, history of angina, type of HCM (apical/classic), maximum left ventricular thickness and left ventricular mass. No significant improvement in Dip-MBF was observed with treatment (1.79â±â0.30 vs.1.76â±â0.26âml/min∗g at baseline; Pâ=â0.59). A limited but significant improvement in Dip-MBF was seen only in the subset without evidence of fibrosis at cardiac MRI (nâ=â4; 28%; 2.03â±â0.13 vs.1.77â±â0.26âml/min∗g at baseline; Pâ=â0.014). The drug was generally well tolerated only one patient temporarily stopped the drug, because of cough.CONCLUSION:
A 6-month perindopril treatment course in HCM patients with CMD was not associated with significant improvement in Dip-MBF. A limited but significant improvement was observed only in the subset of patients without myocardial fibrosis, suggesting potential utility in early disease stages.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cardiomiopatia Hipertrófica
/
Circulação Coronária
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Perindopril
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Tomografia por Emissão de Pósitrons
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Oclusão Coronária
/
Microcirculação
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Cardiovasc Med (Hagerstown)
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Itália