Effect of the cold pressor test on coronary flow reserve by cardiac magnetic resonance in patients with hereditary TTR+ amyloidosis. (3rd October 2022)

• Record Type: Journal Article
• Authors: Chango, D X; Hurtado, A M; Sanchez, M I; Vasquez, Z Y; Gonzalez-Duarte, A; Rosales, S
• Is Part Of: European heart journal. Volume 43(2022)Supplement 2
• Publication Date: 2022-10-03
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehac544.156
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Cold pressor test (CPT) is a potent alpha-adrenergic vasoconstrictor stimulus and evaluates the sympathetic reactivity of the cardiovascular system during the immersion of a hand in cold water, its effect on coronary flow reserve (CFR) in patients with hereditary TTR+ amyloidosis is unknown. Purpose: To evaluate CFR by CPT in hereditary TTR+ amyloidosis patients with different cardiac involvement regarding the distribution of late gadolinium enhancement (LGE) by cardiac magnetic resonance imaging (CMRI) and compare with healthy volunteers Methods: It was a cross-sectional study of 22 hereditary TTR+ amyloidosis patients with different patterns of LGE (absence/minimum or extensive involvement), and 4 healthy controls without LGE. CPT was performed with immersion of one hand in four Celsius degrees temperated water. Phase-contrast images were acquired on rest and during stress (after four minutes of a hand immersion). Volume quantification was made in posterior analysis to determine flow differences. Results: No statistically significant differences were found regarding left ventricular (LV) volumes, LV mass, LV ejection fraction, and atrial volumes comparing the three groups of patients. CFR was abnormal in both groups of TTR+ amyloidosis patients compared with higher values in healthy subjects. Nevertheless, no statistically significant differences were determined. Conclusions: Hereditary TTR+ amyloidosis subjects presented with abnormal values of CFR even with minimal or non-LGE by CMRI in the setting of infiltration. This response hypothesized small vessel involvement due to early infiltration by amyloid deposits before LGE development. Funding Acknowledgement: Type of funding sources: None.