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

Abstract

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

Serum markers of angiogenesis and myocardial ultrasonic tissue characterization in patients with dilated cardiomyopathy

“…Tissue ischemia occurs within the myocardium in DCM, possibly due to a decreased supply caused by microvascular structural and functional abnormalities. Indeed, recent studies have shown that the reduction in myocardial blood flow and volume have been observed in patients with DCM [29,30]. Therefore, it is very likely that the increased serum activity of VEGF in patients with DCM is involved in myocardial perfusion abnormalities.…”

“…CV-IB can be of value in quantifying regional differences in myocardial contractile performance in DCM. Moreover, it is known that the reduction in myocardial blood flow influences attenuation and scattering of myocardial tissue, and could be associated with the deterioration of LV systolic function [29,30]. Accordingly, the increase in serum VEGF may be closely associated with the impaired intrinsic myocardial contractile performance caused by myocardial microvascular abnormalities and myocardial interstitial fibrosis in DCM.…”