Hypertrophic Cardiomyopathy
Conditions
Brief summary
The objective of this study is to determine whether myocardial contrast echocardiography in patients with cardiomyopathy (HCM) can detect resting hypo-perfusion due to fibrosis or stress induced perfusion defects due to associated abnormalities in intramyocardial arteries and the microcirculation. A secondary aim will be to determine whether abnormalities in perfusion are associated with either severity of symptoms (chest pain and dyspnea), presence of arrhythmias, and regional function of the septum.
Interventions
DRUGEcho and myocardial contrast echocardiography perfusion imaging
Myocardial blood flow will be assessed by myocardial contrast echo. Perfusion at rest and stress will be quantified and compared to patient sx, degree of dysfunction on echo strain imaging, and degree of fibrosis on magnetic resonance imaging (when available) that was ordered as part of routine clinical care. Myocardial contrast echocardiography will be performed by intravenous administration of ultrasound contrast agent (Definity or Lumason) using FDA-approved dose limits. Vasodilator stress during MCE imaging will be performed using regadenoson at FDA-approved doses.
Sponsors
Oregon Health and Science University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age 18-80 years * Established diagnosis of HCM
Exclusion criteria
* Known history of coronary or peripheral artery disease * History of myocardial infarction * Pregnant or lactating females * Hypersensitivity to any ultrasound contrast agent * Evidence right-to-left or bi-directional intracardiac shunt * Moderate or greater valve disease other than from HCM (systolic anterior motion of the mitral valve) * History of septal ablation or myectomy * Hemodynamic instability * Pacemaker dependent heart rhythm
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Myocardial perfusion (ml/min/g) in the hypertrophied segment on myocardial contrast echo | One hour | Myocardial contrast echo will be used to measure myocardial perfusion in ml/min/g of tissue in the hypertrophied segment. The data will be analyzed both in terms of absolute value of ml/min/g and also as a ration to normal tissue. |
| Myocardial blood flow reserve in the hypertrophied segment on myocardial contrast echo | One hour | Myocardial blood flow reserve on myocardial contrast echo (ratio of flow during hyperemia to rest) will be calculated for the hypertrophied segment and expressed as an absolute value and relative to normal segments. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Spatial distribution of blood flow on myocardial contrast echocardiography | One hour | Myocardial contrast echocardiography performed at baseline will be analyzed using mathematical algorithms that define how homogenous or heterogenous blood flow distribution is in the hypertrophied segment. These values will be described by wavelet energy levels (dimensionless). |
Countries
United States
Outcome results
None listed