Hypertrophic cardiomyopathy which is known to occasionally have coronary artery disease as concomitant disease may require coronary physiological assessment (Okayama et al., 2015; Shin et al., 2019 [1,2]). However, no study clarified the impact of left ventricular outflow tract obstruction on coronary physiological assessment. Herein, a case of hypertrophic obstructive cardiomyopathy concomitant with moderate coronary lesion was reported, in which dynamic change of physiological values was observed during pharmacological intervention. Specifically, fractional flow reserve (FFR) and resting full-cycle ratio (RFR) changed in an opposite fashion when the left ventricular outflow tract pressure gradient was decreased by intravenous propranolol and cibenzoline: in FFR from 0.83 to 0.79 and in RFR from 0.73 to 0.91. Cardiologists should pay attention to the presence of concomitant cardiovascular disorders in interpreting coronary physiological data.
Keywords: Case report; Coronary artery disease; Coronary physiology; Fractional flow reserve; Left ventricular outflow tract obstruction; Resting full-cycle ratio.
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