The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701).
Background-Despite the major role attributed to myocardial vagal activity in left ventricular arrhythmogenesis in chronic myocardial infarction, the impact of infarction on left ventricular muscarinic receptor density remains unknown. Methods and Results-Left ventricular muscarinic receptor density was measured in vivo by positron emission tomography using the specific antagonist [ 11 C]methylquinuclidinyl benzilate ([ 11 C]MQNB) in 11 patients 43Ϯ20 days after myocardial infarction and 9 healthy volunteers. The extent of myocardial damage was quantified by delayed contrast-enhanced MRI. Three short-axis slices from each subject were analyzed in matched positron emission tomography and MRI images. A 2-injection positron emission tomography protocol was used; [11 C]MQNB timeactivity curves were obtained in 6 regions per slice and fitted to a 3-compartment ligand-receptor model. Four classes of myocardial regions were considered: normal (in volunteers); remote, supplied by healthy or Ͻ70% diameter reduction arteries and without MRI signs of damage; potentially damaged, supplied by infarct-related or Ͼ70% diameter reduction arteries and without signs of damage; and damaged, with damage. The muscarinic receptor density in remote (67Ϯ30 pmol/mL tissue; nϭ86) and potentially damaged (71Ϯ30 pmol/mL tissue; nϭ42) regions of patients was higher than in normal regions of volunteers (32Ϯ17 pmol/mL tissue; nϭ156; PϽ0.001). The muscarinic receptor density in damaged regions (42Ϯ21 pmol/mL tissue; nϭ58) was reduced compared with remote and potentially damaged regions (PϽ0.001) but was not significantly different from normal regions in volunteers (Pϭ0.093).
Conclusions-Vagal
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.