Effect of Intramural Course of Coronary Arteries Assessed by Computed Tomography Angiography in Patients With Hypertrophic Cardiomyopathy

Nassar, Mithal; Arow, Ziad; Monakier, Daniel; Zusman, Oren; Shafir, Gideon; Kornowski, Ran; Hamdan, Ashraf

doi:10.1016/j.amjcard.2019.07.024

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…It is worth noting that the AHA/ACC 2020 guidelines on the diagnosis and treatment of HCM included cardiac CT as an alternative technique to CMR for myocardial tissue characterization and scar detection when considering ICD implantation for primary prevention [ 51 ]. At the same time, it is of paramount importance to recognize that even CCTA images acquired for coronary anatomy evaluation can give information about the myocardial thickness and the myocardial fat infiltration, and it is mandatory to observe and report these non-coronary but cardiac findings [ 52 , 53 , 54 ].…”

Section: Methodsmentioning

confidence: 99%

Coronary Computed Tomography Angiography: Beyond Obstructive Coronary Artery Disease

Tonet

Boccadoro

Micillo

et al. 2023

Life

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Nowadays, coronary computed tomography angiography (CCTA) has a role of paramount importance in the diagnostic algorithm of ischemic heart disease (IHD), both in stable coronary artery disease (CAD) and acute chest pain. Alongside the quantification of obstructive coronary artery disease, the recent technologic developments in CCTA provide additional relevant information that can be considered as “novel markers” for risk stratification in different settings, including ischemic heart disease, atrial fibrillation, and myocardial inflammation. These markers include: (i) epicardial adipose tissue (EAT), associated with plaque development and the occurrence of arrhythmias; (ii) late iodine enhancement (LIE), which allows the identification of myocardial fibrosis; and (iii) plaque characterization, which provides data about plaque vulnerability. In the precision medicine era, these emerging markers should be integrated into CCTA evaluation to allow for the bespoke interventional and pharmacological management of each patient.

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Section: Methodsmentioning

confidence: 99%

Coronary Computed Tomography Angiography: Beyond Obstructive Coronary Artery Disease

Tonet

Boccadoro

Micillo

et al. 2023

Life

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“…These clinical recommendations are supported by some reports highlighting the capability of CCT to adequately assess myocardial structure (40). It is of the utmost importance to recognize that even CCT images acquired for coronary anatomy evaluation are suitable for myocardial thickness quantification and the identification of myocardial fat infiltration (41)(42)(43). To observe and describe these non-coronary but cardiac findings is mandatory, even if a definite diagnosis should be performed with CMR when feasible.…”

Section: Myocardial Tissue Characterizationmentioning

confidence: 98%

The Potential Role of Cardiac CT in the Evaluation of Patients With Known or Suspected Cardiomyopathy: From Traditional Indications to Novel Clinical Applications

Conte

Mushtaq

Muscogiuri

et al. 2021

Front. Cardiovasc. Med.

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After 15 years from its advent in the clinical field, coronary computed tomography (CCTA) is now widely considered as the best first-step test in patients with low-to-moderate pre-test probability of coronary artery disease. Technological innovation was of pivotal importance for the extensive clinical and scientific interest in CCTA. Recently, the advent of last generation wide-coverage CT scans paved the way for new clinical applications of this technique beyond coronary arteries anatomy evaluation. More precisely, both biventricular volume and systolic function quantification and myocardial fibrosis identification appeared to be feasible with last generation CT. In the present review we would focus on potential applications of cardiac computed tomography (CCT), beyond CCTA, for a comprehensive assessment patients with newly diagnosed cardiomyopathy, from technical requirements to novel clinical applications.

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“…Foa et al reported key findings of microvascular remodeling from myectomy specimens, which included luminal narrowing and thickening of the vascular wall [25]. Previous studies reported that the prevalence of myocardial bridging in patients with HCM diagnosed by coronary angiogram was 15-28% and by CT scan was 50-62% [2,[26][27][28]. Notably, previous studies included patients with HCM presenting with chronic stable angina and HF undergoing coronary angiogram or CT scan.…”

Section: Prevalence and Characteristics Of Hcm Patients With Acs-nocamentioning

confidence: 99%

Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy

Puwanant

Trongtorsak

Wanlapakorn

et al. 2021

BMC Cardiovasc Disord

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Objectives Our study aimed to determine the prevalence and prognosis of acute coronary syndrome with non-obstructive coronary artery (ACS-NOCA) in patients with hypertrophic cardiomyopathy (HCM). Methods and results We enrolled a total of 200 consecutive patients with HCM over a 139-month period from 2002 to 2013. The study found that 28 patients (14% of overall patients, 51% of patients with ACS) had ACS-NOCA, and 18 patients (9% of overall patients, 86% of patients with acute MI) had MINOCA as initial clinical presentations. The highest prevalence of non-obstructive coronary artery disease (NOCA) in patients with HCM was found in acute ST-elevation myocardial infarction (STEMI) (100%), followed by non-STEMI (82%), and unstable angina (29%). Patients with ACS-NOCA had more frequent ventricular tachycardia and lower resting left ventricular (LV) outflow tract gradients than those with no ACS-NOCA (p < 0.05 for all). The ACS-NOCA group had a lower probability of HCM-related death compared with the no ACS-NOCA group and the significant coronary artery disease (CAD) group (p-log-rank = 0.0018). Conclusions MINOCA or ACS-NOCA is not an uncommon initial presentation (prevalence rate 9–14%) in patients with HCM. NOCA was highly prevalent (51–86%) in patients with HCM presenting with ACS and had a favorable prognosis. Our findings highlight as a reminder that in an era of rapid reperfusion therapy, ACS in patients with HCM is not only a result of obstructive epicardial CAD, but also stems from the complex cellular mechanisms of myocardial necrosis.

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Effect of Intramural Course of Coronary Arteries Assessed by Computed Tomography Angiography in Patients With Hypertrophic Cardiomyopathy

Cited by 7 publications

References 18 publications

Coronary Computed Tomography Angiography: Beyond Obstructive Coronary Artery Disease

Coronary Computed Tomography Angiography: Beyond Obstructive Coronary Artery Disease

The Potential Role of Cardiac CT in the Evaluation of Patients With Known or Suspected Cardiomyopathy: From Traditional Indications to Novel Clinical Applications

Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy

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