Comorbid CAD and ventricular hypertrophy compromise the perfusion of myocardial tissue at subcritical stenosis of epicardial coronaries

合并冠状动脉疾病和心室肥厚会损害心外膜冠状动脉亚临界狭窄时心肌组织的灌注。

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Abstract

BACKGROUND: Most studies of CAD revascularization have been based on and reported according to angiographic criteria which do not consider the relation between the resulting effective flow distal to the stenosis and the demand of a hypertrophied myocardial tissue. RESULTS: A mathematical model of the myocardial perfusion in comorbid CAD and ventricular hypertrophy, using Poiseuille's law, indicates that the affected patients are more sensitive to CAD-related hemodynamic changes. They are more prone to develop ischemic complications, mainly non-ST-elevation myocardial infarction (NSTEMI), and arrhythmias than their peers with isolated CAD regarding the same degree of coronary stenosis. CONCLUSION: Patients with comorbid CAD and ventricular hypertrophy suffer from myocardial hypoperfusion at subcritical epicardial stenosis. Accordingly, the comorbidity of both diseases should be considered upon designing of the treatment regimen.

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