J Cardiovasc Ultrasound.  2016 Mar;24(1):64-67. 10.4250/jcu.2016.24.1.64.

Abnormal Myocardial Blood Flow Reserve Observed in Cardiac Amyloidosis

• Nam MC
• Nel K
• Senior R
• Greaves K

• KMID: 2160998
• DOI: http://doi.org/10.4250/jcu.2016.24.1.64

Abstract

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.

Keyword

Myocardial blood flow; Myocardial blood flow reserve; Contrast echocardiography; Cardiac amyloidosis; Echocardiography

MeSH Terms

Amyloidosis*
Chest Pain
Coronary Angiography
Dipyridamole
Echocardiography
Humans
Hyperemia
Microbubbles
Phenobarbital
Plaque, Amyloid
Dipyridamole
Phenobarbital