| Carbon-11 hydroxyephedrine with positron emission tomography for serial assessment of cardiac adrenergic neuronal function after acute myocardial infarction in humans. | |
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MedLine Citation:
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PMID: 8335806 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to assess the extent and reversibility of neuronal abnormalities in patients with an acute myocardial infarction. BACKGROUND: Previous experimental studies have described ischemic injury to sympathetic neurons exceeding the area of myocardial necrosis. Carbon-11 (C-11) hydroxyephedrine (HED) is a norepinephrine analogue that can be used for the noninvasive evaluation of neuronal integrity using positron emission tomography. METHODS: We studied 14 volunteers and 16 patients experiencing a first acute myocardial infarction. Positron emission tomographic imaging was used to quantitatively compare regional perfusion, as assessed with nitrogen-13 ammonia, with myocardial retention of C-11 hydroxyephedrine early after myocardial infarction as well as > 6 months after the acute event. RESULTS: C-11 hydroxyephedrine and flow images demonstrated homogeneous tracer retention in volunteers but were abnormal in all patients. C-11 hydroxyephedrine abnormalities were more extensive than those for blood flow assessed by semiquantitative polar map analysis (31 +/- 15% vs. 17 +/- 17% left ventricle; p < 0.05), particularly in five patients with non-Q wave infarction (31 +/- 11% vs. 3.5 +/- 2.5% left ventricle; p = 0.008). Eleven patients with Q wave infarction had matched defects (28 +/- 17% vs. 21 +/- 17% left ventricle; p = NS). C-11 hydroxyephedrine tissue retention fraction was quantified in three tissue zones: zone 1 (abnormal rest flow) had retention fraction 0.037 +/- 0.022-min; zone 2 (normal rest flow but decreased carbon-11 hydroxyephedrine retention) had retention fraction 0.068 +/- .034-min, and zone 3 (normal flow and carbon-11 hydroxyephedrine retention) had retention fraction 0.087 +/- 0.041-min (p = 0.0004). Follow-up studies at 8 +/- 3 months in eight patients revealed no change in extent of abnormalities or absolute tissue tracer retention in infarct and peri-infarct territories. CONCLUSIONS: The results of abnormal regional sympathetic innervation in patients with infarction confirm previous experimental data and suggest persistent neuronal damage in infarct and peri-infarct territories, without evidence of reinnervation of reversibly injured myocardium. |
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Authors:
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K C Allman; D M Wieland; O Muzik; T R Degrado; E R Wolfe; M Schwaiger |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 22 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1993 Aug |
Date Detail:
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Created Date: 1993-08-24 Completed Date: 1993-08-24 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 368-75 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, University of Michigan, Ann Arbor. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic Fibers
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physiology* Adult Aged Autonomic Nervous System Diseases / etiology, radionuclide imaging* Carbon Radioisotopes / diagnostic use Case-Control Studies Coronary Circulation Ephedrine / analogs & derivatives*, diagnostic use Female Follow-Up Studies Heart / innervation, physiopathology, radionuclide imaging* Humans Male Middle Aged Myocardial Infarction / complications, physiopathology, radionuclide imaging* Sympathomimetics / diagnostic use* Tomography, Emission-Computed |
| Grant Support | |
ID/Acronym/Agency:
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R01 HI 47543/HI/NHLBI NIH HHS; R01 HL27555/HL/NHLBI NIH HHS; R01 HL4107/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Carbon Radioisotopes; 0/Sympathomimetics; 299-42-3/Ephedrine; 3002-40-2/3-hydroxyephedrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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