Prognostic utility of myocardial blood flow assessed by N-13 ammonia positron emission tomography in patients with idiopathic dilated cardiomyopathy

Shikama, Nobuaki; Himi, Toshiharu; Yoshida, Katsuya; Nakao, Motohiro; Fujiwara, Masaki; Tamura, Takashi; Yamanouchi, Masato; Nakagawa, Keiichi; Kuwabara, Yoichi; Toyozaki, Tetsuya; Masuda, Yoshiaki

doi:10.1016/s0002-9149(99)00329-x

Cited by 25 publications

(15 citation statements)

References 24 publications

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“…In studies of DCM patients predominantly without LBBB, 26 patients with moderate DCM (24 without LBBB, 2 with LBBB, EF 36F10%) and 4 patients with severe DCM (3 without LBBB, 1 with LBBB, EF 21F5%) revealed no significant regional differences in MBF [29,41]. Together with our results, these studies suggest that regional differences and substantial inhomogeneities of MBF and MVO 2 are not induced by the state of DCM but by LBBB.…”

Section: Regional Mvo 2 and Mbf In Dcm Patients With And Without Lbbbsupporting

confidence: 74%

Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block

Lindner

Vogt

Baller

et al. 2005

European Journal of Heart Failure

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Objective: In patients with dilated cardiomyopathy (DCM), left bundle branch block (LBBB) is a common finding. The characteristic feature is an asynchronous septal wall motion and most frequently a delay of the lateral and/or posterior wall segments. With the onset of cardiac resynchronization therapy, there is a focus on the specific pathophysiology of a LBBB. However, quantitative data on regional myocardial oxygen consumption (MVO 2 ) and blood flow (MBF) are missing. Methods: We studied 31 patients with severe DCM and LBBB (ejection fraction 22.1F7.1%) and 14 patients with mild to moderate DCM without LBBB (ejection fraction 46.7F7.9%). Global and regional MVO 2 as well as MBF were determined from a dynamic 11 C-acetate positron emission tomography (PET) study. Results: Global MVO 2 and MBF were lower in the DCM group with LBBB than in the control group ( Pb0.05). Regionally, the LBBB group revealed a higher ( Pb0.05) MVO 2 and MBF in the lateral wall than in the other walls. The control group did not show significant differences between the myocardial walls and demonstrated a smaller variability of the parameters. Conclusion: DCM patients with LBBB exhibit a more heterogeneous distribution of MVO 2 and MBF among the myocardial walls than DCM patients without LBBB. Due to the LBBB associated electromechanical alterations, the highest regional values of MVO 2 and MBF are found in the lateral wall.

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Section: Regional Mvo 2 and Mbf In Dcm Patients With And Without Lbbbsupporting

confidence: 74%

Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block

Lindner

Vogt

Baller

et al. 2005

European Journal of Heart Failure

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“…21 These discrepancies do not seem to be attributable to different methods in MBF measurements, because a depression of resting MBF was demonstrated in several other studies performed in patients with dilated cardiomyopathy with different methodological approaches. Discrepancies most probably could be explained by different sample sizes.…”

Section: Pathophysiological Role Of Depressed Mbf In Idiopathic LV Dymentioning

confidence: 97%

Prognostic Role of Myocardial Blood Flow Impairment in Idiopathic Left Ventricular Dysfunction

et al. 2002

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Background-Depressed myocardial blood flow (MBF) has been reported in dilated cardiomyopathy. The aim of this study was to investigate whether MBF impairment is an independent predictor of prognosis in patients with idiopathic left ventricular (LV) dysfunction. Methods and Results-Sixty-seven patients (52 male, mean age 52Ϯ12 years) with different degrees of idiopathic LV systolic dysfunction (average LV ejection fraction, 0.34Ϯ0.10; range, 0.07 to 0.49) were prospectively enrolled. Thirty-four subjects (51%) had no history of heart failure symptoms at enrollment (NYHA class I). All patients underwent clinical and functional evaluation and a PET study to measure absolute MBF at rest and after intravenous dipyridamole. During a mean follow-up of 45Ϯ37 months, 24 patients had major cardiac events, including cardiac death in 8 and development or progression of heart failure in 16 patients. Multivariate regression analysis (Cox proportional hazards model) revealed heart rate ( 2 11.06, PϽ0.001), LV end-diastolic dimension ( 2 11.73, PϽ0.001), and dipyridamole MBF ( 2 11.04, PϽ0.001) as independent predictors of subsequent cardiac events. Dipyridamole MBF Յ1.36 mL ⅐ min Ϫ1 ⅐ g Ϫ1 was associated with an increase in the relative risk of death, development, or progression of heart failure of 3.5 times over other more common clinical and functional variables. Conclusions-The present study demonstrates that severely depressed MBF is a predictor of poor prognosis in patients with idiopathic LV dysfunction independently of the degree of LV functional impairment and of the presence of overt heart failure.

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“…17,18 Recent advances in contrast agents and ultrasound technology have enabled us to assess the pathophysiological conditions of the coronary microcirculation using MCE. 19 A recent study has demonstrated that MCE-derived PMCI is a potent variable for evaluating myocardial microvascular and capillary density in ischemic dysfunctional hearts.…”

Section: Myocardial Blood Volume Abnormalities In Idcmentioning

confidence: 99%

Relation of Myocardial Blood Volume to Left Ventricular Function and Future Cardiac Events in Patients With Idiopathic Dilated Cardiomyopathy

Inoue

Hamada

Ohtsuka

et al. 2004

Circ J

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revious reports have demonstrated that myocardial microvascular damage is related to left ventricular (LV) dysfunction in patients with heart failure. 1,2 LV contractile dysfunction is associated with an increased incidence of morbidity and mortality in patients with heart failure, 3,4 so it is important for the optimum treatment of patients with heart failure to assess any myocardial microvascular damage in detail. A recent study used positron emission tomography to demonstrate that myocardial perfusion abnormalities occur in patients with idiopathic dilated cardiomyopathy (IDC); 5 however, there is the clinical issue of the inability to perform repetitive testing with this technique.Recently, intravenous transpulmonary contrast agents and ultrasound technology have been developed and intravenous myocardial contrast echocardiography (MCE) has been used to assess myocardial blood volume in various cardiovascular diseases, such as myocardial infarction, 6 and its efficacy and safety are generally accepted. 7,8 Therefore, we used this new echocardiographic technique to assess myocardial blood volume in patients with IDC. We further evaluated the relation between the myocardial blood volume derived from MCE and the LV performance, and examined the prognostic role of this parameter in patients

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Prognostic utility of myocardial blood flow assessed by N-13 ammonia positron emission tomography in patients with idiopathic dilated cardiomyopathy

Cited by 25 publications

References 24 publications

Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block

Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block

Prognostic Role of Myocardial Blood Flow Impairment in Idiopathic Left Ventricular Dysfunction

Relation of Myocardial Blood Volume to Left Ventricular Function and Future Cardiac Events in Patients With Idiopathic Dilated Cardiomyopathy

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