{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:42:56Z","timestamp":1771918976567,"version":"3.50.1"},"reference-count":0,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T00:00:00Z","timestamp":1698105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Coronary microvascular dysfunction (CMD) is a pathophysiological mechanism underlying hypertrophic obstructive cardiomyopathy (HOCM). However, few studies have investigated the potential effect of transapical beating-heart septal myectomy (TA-BSM) on coronary microvascular function. This study aimed to evaluate coronary microvascular function in HOCM after TA-BSM using cardiac magnetic resonance (CMR) and to investigate the determinants of improvement in coronary microvascular dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>28 patients with HOCM who underwent TA-BSM were prospectively enrolled in this study from March 2022 to April 2023. All patients received CMR before and after TA-BSM. CMR-derived parameters were compared, including the maximum wall thickness, native T1 value, T2 value, late gadolinium enhancement (LGE), and perfusion indexes (Slope<jats:sub>max<\/jats:sub>, Time<jats:sub>max<\/jats:sub>, and Sl<jats:sub>max<\/jats:sub>). Univariate and multivariate linear regression identified variables associated with the rate of Slope<jats:sub>max<\/jats:sub> change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with the preoperative parameters, left ventricular function and myocardial perfusion were significantly improved after TA-BSM (all <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05), although still lower than in healthy controls. In the analysis of the myocardial perfusion parameter rate of change, the rate of Slope<jats:sub>max<\/jats:sub> change was the most significant (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) in HOCM. In the multivariable regression analysis, age (adjusted <jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.551), weight of the resected myocardium (adjusted <jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.191), maximum wall thickness (adjusted <jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.406), LGE (adjusted <jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.260), and \u0394 left ventricular outflow tract (LVOT) pressure gradient (adjusted <jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.123) were significantly associated with the rate of Slope<jats:sub>max<\/jats:sub> change in HOCM (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05 for all).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Coronary microvascular dysfunction in both hypertrophic and non-hypertrophic myocardial segments was improved in patients after TA-BSM. Microcirculatory perfusion evaluated by CMR can be a potential tool to evaluate the improvement of CMD in HOCM.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1233004","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T06:13:16Z","timestamp":1698214396000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Improvement in coronary microvascular dysfunction evaluated by cardiac magnetic resonance in patients with hypertrophic obstructive cardiomyopathy after transapical beating-heart septal myectomy"],"prefix":"10.3389","volume":"10","author":[{"given":"Yun","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenhe","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dazhong","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunlin","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyue","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liming","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,24]]},"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1233004\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T06:13:18Z","timestamp":1698214398000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1233004\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,24]]},"references-count":0,"alternative-id":["10.3389\/fcvm.2023.1233004"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1233004","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,24]]},"article-number":"1233004"}}