کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2959998 | 1178342 | 2013 | 9 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Impairment of Subendocardial Perfusion Reserve and Oxidative Metabolism in Nonischemic Dilated Cardiomyopathy Impairment of Subendocardial Perfusion Reserve and Oxidative Metabolism in Nonischemic Dilated Cardiomyopathy](/preview/png/2959998.png)
BackgroundCardiac magnetic resonance (CMR) and [11C]acetate positron emission tomography (PET) were used to assess the hypothesis that patients with nonischemic dilated cardiomyopathy (NIDCM) have decreased subendocardial perfusion reserve and impaired oxidative metabolism, consistent with the concept of “energy starvation” in heart failure (HF).Methods and ResultsCMR myocardial perfusion was evaluated in 13 NIDCM patients and 15 control subjects with coronary risk factors and normal myocardial perfusion. The NIDCM patients underwent [11C]acetate PET. The myocardial perfusion index (MPI) was calculated as the normalized rate of myocardial signal augmentation following gadolinium contrast injection. Hyperemic transmural, subendocardial, and subepicardial MPI were reduced in NIDCM compared with control subjects [0.13 vs 0.18 (P < .001), 0.13 vs 0.17 (P < .001), and 0.13 vs 0.17 (P = .008), respectively]. The subendocardial perfusion reserve was 1.59 ± 0.21 vs 1.86 ± 0.32 for the subepicardium (P = .002), demonstrating reduced perfusion reserve. The myocardial oxidative metabolic rate (kmono) per unit demand (rate-pressure product) was reduced in proportion to perfusion reserve (P = .02)ConclusionsImpaired subendocardial perfusion reserve in NIDCM confirmed results previously attained only in animal models. Impaired perfusion and impaired oxidative metabolism are consistent with subendocardial energy starvation in HF.
Journal: Journal of Cardiac Failure - Volume 19, Issue 12, December 2013, Pages 802–810