Document Detail

13N-ammonia rest/stress PET: folic acid improves global coronary vasoreactivity in coronary artery disease patients with normal or elevated homocysteine levels.
MedLine Citation:
PMID:  17149493     Owner:  NLM     Status:  MEDLINE    
AIM: Hyperhomocysteinaemia (Hhcy) is known to be an independent risk factor for vascular disease. Coronary flow reserve (CFR) measured by positron emission tomography (PET) is a sensitive method to monitor the effects of pharmacologic interventions in Hhcy. We assessed coronary vascular reactivity by PET in patients with coronary artery disease (CAD) dependent on their homocysteine (Hcy) levels before and under high dose folic acid supplementation therapy (FAST). PATIENTS, METHODS: Twelve patients with CAD underwent rest/adenosine (13) N-ammonia PET for quantification of myocardial blood flow (MBF) and CFR before and after nine weeks FAST (10 mg/day). RESULTS: Folate levels increased from 21 +/- 6 to 210 +/- 34 microg/l (+900%, p < 0.0001) while Hcy levels decreased from 12.1 +/- 3.6 to 9.1 +/- 3.1 micromol/l ( - 25%; p < 0.01). Global resting MBF remained nearly unchanged after FAST, while stress MBF (from 2.61 +/- 0.93 to 3.25 +/- 1.15 ml/g/min; p = 0.05) and CFR (from 3.00 +/- 0.76 to 3.72 +/- 0.93 ml/g/min; p < 0.05; +24%) significantly increased in patients with normal and elevated Hcy levels (cut off 12 micromol/l). An inverse relation was found between Hcy and CFR (R = - 0.53; p = 0.08) and between Hcy and MBF at rest (R = - 0.62; p < 0.05) at baseline conditions, not persisting after FAST. CONCLUSION: Coronary vascular reactivity can be improved by FAST in patients with CAD and normal or elevated Hcy levels. FAST might lower an increased cardiovascular risk in CAD patients possibly by mechanisms that are not related to Hcy.
S Graf; M Nikfardjam; A Khorsand; S Ofluoglu; S Nekolla; R Dudczak; G Maurer; K Kletter; K Huber; C Pirich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nuklearmedizin. Nuclear medicine     Volume:  45     ISSN:  0029-5566     ISO Abbreviation:  Nuklearmedizin     Publication Date:  2006  
Date Detail:
Created Date:  2006-12-06     Completed Date:  2007-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609387     Medline TA:  Nuklearmedizin     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  248-53     Citation Subset:  IM    
Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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MeSH Terms
Coronary Angiography
Coronary Disease / radiography*
Exercise Test*
Folic Acid / diagnostic use*,  therapeutic use*
Homocysteine / blood*
Hyperhomocysteinemia / blood
Middle Aged
Nitrogen Radioisotopes / diagnostic use*
Positron-Emission Tomography
Reference Values
Reg. No./Substance:
0/Nitrogen Radioisotopes; 454-28-4/Homocysteine; 59-30-3/Folic Acid; 7664-41-7/Ammonia

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