CLINICAL CHARACTERISTICS IN JAPANESE PATIENTS WITH COEXISTENT HYPERTROPHIC CARDIOMYOPATHY AND CORONARY VASOSPASM

There are only a few reports concerning coexistent hypertrophic cardio myopathy (HCM) and vasospastic angina. Clinical characteristics in pat ients with both diseases have not been clarified yet. This study was d esigned to elucidate the relationship between chest pain and coronary vasospasm in HCM patients and to delineate clinical characteristics in patients with both HCM and coronary vasospasm. First, 36 patients wit h HCM underwent acetylcholine provocation test for coronary vasospasm and were divided into two groups on the basis of presence or absence o f coronary vasospasm. Next, the following risk factors for coronary ar tery disease were compared between the two groups: hypertension, smoki ng, hyperlipidemia, diabetes mellitus, and hyperuricemia. Coronary vas ospasm was induced in 10 (28%) of 36 patients with HCM. There were no significant differences in age and male gender between the two groups. Smoking was more prominent in HCM patients with than without coronary vasospasm (80% vs 35%, p<0.05), but there were no differences in the prevalence of other risk factors between the two groups. In conclusion , coronary vasospasm appears to play a significant role in the etiolog y of myocardial ischemia in Japanese patients with HCM, and smoking mi ght be a major risk factor for coexistence of HCM and coronary vasospa sm.