Document Detail


Carbon-11 hydroxyephedrine with positron emission tomography for serial assessment of cardiac adrenergic neuronal function after acute myocardial infarction in humans.
MedLine Citation:
PMID:  8335806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
K C Allman; D M Wieland; O Muzik; T R Degrado; E R Wolfe; M Schwaiger
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Publication Detail:
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:
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:
Created Date:  1993-08-24     Completed Date:  1993-08-24     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  368-75     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic Fibers / 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:
R01 HI 47543/HI/NHLBI NIH HHS; R01 HL27555/HL/NHLBI NIH HHS; R01 HL4107/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
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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