Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Regional myocardial blood flow reserve impairment and metabolic changes suggesting myocardial ischemia in patients with idiopathic dilated cardiomyopathy
Autore:
van den Heuvel, AFM; van Veldhuisen, DJ; van der Wall, EE; Blanksma, PK; Siebelink, HMJ; Vaalburg, WM; van Gilst, WH; Crijns, HJGM;
Indirizzi:
Univ Groningen Hosp, Ctr Thorax, Dept Cardiol, Dept Thoraxctr, NL-9700 RB Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands NL-9700 RB ningen, Netherlands Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands Leiden Univ Leiden Netherlands d Ctr, Dept Cardiol, Leiden, Netherlands Univ Groningen Hosp, Natl Positron Emiss Tomog Ctr, NL-9700 RB Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands NL-9700 RB ningen, Netherlands
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 1, volume: 35, anno: 2000,
pagine: 19 - 28
SICI:
0735-1097(200001)35:1<19:RMBFRI>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITRON-EMISSION TOMOGRAPHY; CONGESTIVE-HEART-FAILURE; POLAR MAP DISPLAYS; OXIDATIVE-METABOLISM; CARDIAC PET; GLUCOSE-UTILIZATION; OXYGEN-CONSUMPTION; N-13 AMMONIA; VALIDATION; DOBUTAMINE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: van Veldhuisen, DJ Univ Groningen Hosp, Ctr Thorax, Dept Cardiol, Dept Thoraxctr, POB 30-001,NL-9700 RB Groningen, Netherlands Univ Groningen Hosp POB 30-001 Groningen Netherlands NL-9700 RB
Citazione:
A.F.M. van den Heuvel et al., "Regional myocardial blood flow reserve impairment and metabolic changes suggesting myocardial ischemia in patients with idiopathic dilated cardiomyopathy", J AM COL C, 35(1), 2000, pp. 19-28

Abstract

OBJECTIVES We performed positron emission tomography (PET) to evaluate myocardial ischemia in patients with idiopathic dilated cardiomyopathy (IDC). BACKGROUND Patients with IDC have anatomically normal coronary arteries, and it has been assumed that myocardial ischemia does not occur. METHODS We studied 22 patients with IDC and 22 control subjects using PET with nitrogen-13 ammonia to measure myocardial blood flow (MBF) at rest andduring dipyridamole-induced hyperemia. To investigate glucose metabolism, fluorine-18 deoxyglucose ((18)FDG) was used. For imaging of oxygen consumption, carbon-ii acetate clearance rate constants (k(mono)) were assessed at rest and during submaximal dobutamine infusion (20 mu g/kg body weight per min). RESULTS Global MBF reserve (dipyridamole-induced) was impaired in patientswith IDC versus control subjects (1.7 +/- 0.21 vs. 2.7 +/- 0.10, p < 0.05). In patients with IDC, MBF reserve correlated with left ventricular (LV) systolic wall stress (r = -0.61, p = 0.01). Furthermore, in 16 of 22 patients with IDC (derived by dipyridamole perfusion) mismatch (decreased flow/increased (18)FDG uptake) was observed in 17 +/- 8% of the myocardium. The extent of mismatch correlated with LV systolic wall stress (r = 0.64, p = 0.02). The MBF reserve was lower in the mismatch regions than in the normal regions (1.58 +/- 0.13 vs. 1.90 +/- 0.18, p < 0.05). During dobutamine infusion k(mono) was higher in the mismatch regions than in the normal regions (0.104 +/- 0.017 vs. 0.087 +/- 0.016 min(-1), p < 0.05). In the mismatch regions (18)FDG uptake correlated negatively with rest k(mono) (r = -0.65, p < 0.05), suggesting a switch from aerobic to anaerobic metabolism. CONCLUSIONS Patients with IDC have a decreased MBF reserve. In addition, low MBF reserve was paralleled by high LV systolic wall stress. These globalobservations were associated with substantial myocardial mismatch areas showing the lowest MBF reserves. In geographically identical regions an abnormal oxygen consumption pattern was seen together with a switch from aerobicto anaerobic metabolism. These data support the notion that regional myocardial ischemia plays a role in IDC. (C) 1999 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 01:03:04