PET-measured heterogeneity in longitudinal myocardial blood flow in response to sympathetic and pharmacologic stress as a non-invasive probe of epicardial vasomotor dysfunction

Details

Serval ID
serval:BIB_2F78D1029621
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
PET-measured heterogeneity in longitudinal myocardial blood flow in response to sympathetic and pharmacologic stress as a non-invasive probe of epicardial vasomotor dysfunction
Journal
European Journal of Nuclear Medicine and Molecular Imaging
Author(s)
Schindler  T. H., Facta  A. D., Prior  J. O., Campisi  R., Inubushi  M., Kreissl  M. C., Zhang  X. L., Sayre  J., Dahlbom  M., Schelbert  H. R.
ISSN
1619-7070
Publication state
Published
Issued date
10/2006
Peer-reviewed
Oui
Volume
33
Number
10
Pages
1140-9
Notes
Journal Article
Research Support, N.I.H., Extramural --- Old month value: Oct
Abstract
PURPOSE: We investigated whether a myocardial perfusion gradient during pharmacologically induced hyperemia also occurred during sympathetic stimulation with cold pressor testing (CPT), which commonly induces a paradoxical coronary vasoconstriction in individuals with coronary risk factors. METHODS: Myocardial blood flow (MBF) was measured in absolute units (ml/g/min) with 13N-ammonia and PET at rest, during CPT, and during pharmacologic vasodilation in 59 participants with coronary risk factors ("at risk") and in 43 healthy individuals (controls). MBF was assessed globally as mean MBF, and in the mid and mid-distal myocardium of the left ventricle (LV). A decrease in MBF from mid to mid-distal LV myocardium was defined as MBF difference indicative of a perfusion gradient. RESULTS: The change in mean MBF to CPT (DeltaMBF) in the at-risk group was significantly reduced compared with controls (0.05+/-0.19 vs 0.31+/-0.20 ml/g/min, p<0.0001), whereas mean MBF during pharmacologic vasodilation in the at-risk group tended to be lower than in controls (1.72+/-0.71 vs 2.00+/-0.64 ml/g/min, p=NS). Absolute MBFs during CPT and pharmacologic vasodilation were significantly lower in the mid-distal than in the mid LV myocardium, resulting in a significant MBF difference in the at-risk group (0.15+/-0.06 and 0.27+/-0.12 ml/g/min, p<0.0001) that was not observed in controls (0.007+/-0.05 and 0.014+/-0.10 ml/g/min, p=NS). In the at-risk group there was a significant correlation between the difference of mid to mid-distal MBF during CPT and that during pharmacologic vasodilation (r=0.43, p<0.004), suggesting functional alterations of epicardial vessels as the predominant cause for the observed MBF difference. CONCLUSION: The relative decrease in MBF from the mid to the mid-distal left-ventricular myocardium suggests an intracoronary pressure decline during CPT and pharmacologic vasodilation, which is likely to reflect an impairment of flow-mediated epicardial vasomotor function.
Keywords
Adult Ammonia/diagnostic use Blood Flow Velocity Carbon Radioisotopes/diagnostic use Cold/diagnostic use *Coronary Circulation Exercise Test/methods Female Humans Male Pericardium/*physiopathology/*radionuclide imaging Positron-Emission Tomography/*methods Radiopharmaceuticals/diagnostic use Sympathetic Nervous System/*physiopathology Vasodilator Agents/*diagnostic use Vasomotor System/*radionuclide imaging
Pubmed
Web of science
Create date
29/01/2008 16:38
Last modification date
20/08/2019 13:13
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