Coronary arterial vasculature in the pathophysiology of hypertrophic cardiomyopathy

  • Richard J. Marszalek
  • R. John Solaro
  • Beata M. Wolska
Invited Review


Alterations in the coronary vascular system are likely associated with a mismatch between energy demand and energy supply and critical in triggering the cascade of events that leads to symptomatic hypertrophic cardiomyopathy. Targeting the early events, particularly vascular remodeling, may be a key approach to developing effective treatments. Improvement in our understanding of hypertrophic cardiomyopathy began with the results of early biophysical studies, proceeded to genetic analyses pinpointing the mutational origin, and now pertains to imaging of the metabolic and flow-related consequences of such mutations. Microvascular dysfunction has been an ongoing hot topic in the imaging of genetic cardiomyopathies marked by its histologically significant remodeling and has proven to be a powerful asset in determining prognosis for these patients as well as enlightening scientists on a potential pathophysiological cascade that may begin early during the developmental process. Here, we discuss questions that continue to remain on the mechanistic processes leading to microvascular dysfunction, its correlation to the morphological changes in the vessels, and its contribution to disease progression.


Hypertrophic cardiomyopathy Microvascular Ischemia Pathogenesis Energetics 



We would also like to thank Jin Lim for illustrating Fig. 1.

Funding information

This study received financial support from the following: NIH NHLBI PO1 HL 62426 (RJS, BMW); RO1 HL128468 (BMW, RJS), and T32 HL139439 (RJM).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Richard J. Marszalek
    • 1
    • 2
    • 3
  • R. John Solaro
    • 1
    • 2
    • 3
  • Beata M. Wolska
    • 1
    • 4
  1. 1.Department of Physiology and Biophysics and the Center for Cardiovascular ResearchUniversity of Illinois at ChicagoChicagoUSA
  2. 2.College of MedicineUniversity of Illinois at ChicagoChicagoUSA
  3. 3.Department of Physiology and Biophysics (M/C 901), College of MedicineUniversity of Illinois at ChicagoChicagoUSA
  4. 4.Department of Medicine, Division of Cardiology, College of MedicineUniversity of Illinois at ChicagoChicagoUSA

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