Role of “Ischemia Modified Albumin” in detecting myocardial ischemia in hypertrophic cardiomyopathy.

Background. Myocardial ischemic events are well known to occur in patients with hypertrophic cardiomyopathy (HCM) as a consequence of small vessel disease and mismatch between left ventricular hypertrophy and coronary flow. Ischemia modified albumin (IMA) has been recently suggested as an early marker of reversible myocardial ischemia in acute coronary syndromes. Aim of this study is to evaluate the role of IMA in detecting myocardial ischemia in HCM patients. Methods. IMA, cTnI, cTnT and high sensitivity C reactive protein (hs CRP) concentrations were measured in 42 HCM pts, 15 female (36%) and 27 male (64%), aged from 13 to 76 years (mean age 42,4±16.8). Peripheral venous blood samples were taken after 30 minutes supine position. IMA was measured by the Albumin Cobalt Binding test (Ischemia Technologies, USA). IMA values ≥100 KU/L (mean value in 107 controls), were considered positive for ischemia. Clinical data, ST depression, and maximal left ventricular wall thickness (MLVWT) were collected. Cardiac Magnetic Resonance (CMR) acquiring cine images, T2- weighted sequences for edema and late-enhancement (LE) sequences was performed in 24 pts and coronary angiography in 10 pts. Results. Conclusions. IMA levels are elevated in 50% of HCM patients. Therapy with Verapamil is significantly associated to normal levels of IMA but this interesting result needs be confirmed in a larger HCM population.