Multifactorial determinants of reduced coronary flow reserve after dipyridamole in dilated cardiomyopathy
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2019, Heart Failure ClinicsCitation Excerpt :When maladaptive eccentric LVH occurs, because of an elevation in ventricular wall stress, MVo2 rises and this may lead to the exhaustion of coronary blood flow reserve.49 This underperfusion may be responsible for the development of subendomyocardial ischemia.50–52 Coronary hemodynamic changes in the microcirculation may contribute to the onset of myocyte loss and to the formation of myocardial fibrosis.53,54
Left Bundle Branch Block Negatively Affects Coronary Flow Velocity Reserve and Myocardial Contractile Reserve in Nonischemic Dilated Cardiomyopathy
2016, Journal of the American Society of EchocardiographyCitation Excerpt :In a study using positron emission tomography, absolute myocardial blood flow measurements facilitated the recognition of globally impaired responsiveness to vasodilators in patients with heart failure of nonischemic etiology and characterized by diffuse microvascular disease, such as DCM.19 Several mechanisms can be recognized for the CFVR impairment in DCM (and in conditions without obstructive coronary artery disease), such as microvascular remodeling, smooth muscle dysfunction, extramural compression, reduced diastolic perfusion time (increased intramyocardial pressure or tissue edema), vascular wall infiltration, vascular rarefaction, perivascular fibrosis including LV hypertrophy, diastolic wall stress, end-diastolic pressure, and coronary small vessel disease.2,18-23 All these factors can contribute with relative importance in different clinical conditions and may coexist.
Effects of Allopurinol on Coronary Microvascular and Left Ventricular Function in Patients With Idiopathic Dilated Cardiomyopathy
2012, Canadian Journal of CardiologyPrognostic value of left and right coronary flow reserve assessment in nonischemic dilated cardiomyopathy by transthoracic doppler echocardiography
2011, Journal of Cardiac FailureCitation Excerpt :Myocardial hypertrophy can lower coronary flow, but LV hypertrophy is unlikely to be an important determinant of CFR reduction in nonischemic DCM patients.19 High LV end-diastolic pressure lowers CFR by exerting an elevated extravascular diastolic compression on the coronary microvasculature, hindering maximal vasodilatation.19–21 Accordingly, we demonstrated a relationship between diastolic dysfunction and diffuse impairment in CFR with higher incidence of restrictive transmitral pattern in patients with lower CFR in LAD and PD.
Coronary Flow Reserve in Idiopathic Dilated Cardiomyopathy: Relation with Left Ventricular Wall Stress, Natriuretic Peptides, and Endothelial Dysfunction
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2008, Journal of the American College of Cardiology