| Cardiac sympathetic denervation in patients with coronary artery disease without previous myocardial infarction. | |
| | |
MedLine Citation:
|
PMID: 9264418 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Myocardial infarction damages sympathetic nerve fibers coursing through the infarct zone. In this study we investigated whether coronary artery disease without myocardial infarction results in sympathetic denervation. We examined 12 patients without a history of previous myocardial infarction and 19 postinfarction patients. 1-123 metaiodobenzylguanidine (MIBG) and technetium-99m sestamibi (MIBI) single-photon emission tomography were conducted at rest to determine the extent of denervated myocardium and the extent of myocardium with reduced perfusion, respectively. In addition, myocardial perfusion during exercise was assessed with MIBI. A MIBG or MIBI defect was determined as being regional uptake of < or =30% of the maximal myocardial activity. All but 1 patient without previous infarction had MIBG defects. MIBG defects (10.3 +/- 8.5% of left ventricular mass) were significantly larger than MIBI defects at rest (2.4 +/- 3.2%, p <0.001) and during exercise (4.8 +/- 6.1%, p <0.05). In multiregression analysis, the size of an MIBG defect was associated with severity of coronary stenoses (> or =90% of lumen diameter; p <0.05), but not with age, number of significant stenoses (> or =50% of lumen diameter), left main disease, functional class, left ventricular ejection fraction, angina pectoris, maximal ST depression, or mean workload during exercise test. MIBG and MIBI defects were significantly larger in patients with severe coronary stenoses than in patients with moderate stenoses (50% to 89% of lumen diameter) (16.4 +/- 8.9% vs 6.0 +/- 5.2% [p <0.05] and 5.0 +/- 3.1% vs 0.6 +/- 1.3% [p <0.001], respectively). The size of MIBG (16.1 +/- 8.9%) and MIBI defects (7.3 +/- 6.5%) at rest in postinfarction patients did not differ from patients with severe stenoses. Our study demonstrates that cardiac adrenergic tissue is very sensitive to ischemia and that regional cardiac sympathetic denervation can occur in patients with stable coronary artery disease without previous myocardial infarction. |
| | |
Authors:
|
J Hartikainen; J Mustonen; J Kuikka; E Vanninen; R Kettunen |
Related Documents
:
|
21078778 - Myocardial spect images for diagnosis of pulmonary hypertension and right ventricular h... 6608548 - Quantitative analysis of seven-pinhole tomographic thallium-201 scintigrams: improved s... 3371378 - Increased 201tl uptake by the chest wall following cardioversion. 11354578 - Effects of transmyocardial revascularization on myocardial perfusion and systolic funct... 14980008 - Antihypertensive and anti-arrhythmic effects of an extract of radix stephaniae tetrandr... 23442808 - Right heart morphology and function in heart transplantation recipients. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The American journal of cardiology Volume: 80 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1997 Aug |
Date Detail:
|
Created Date: 1997-09-04 Completed Date: 1997-09-04 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 273-7 Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine, Kuopio University Hospital, Finland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Coronary Disease / pathology*, physiopathology Exercise Test Female Heart / innervation* Humans Male Middle Aged Myocardium / pathology Radiopharmaceuticals / diagnostic use Sympathetic Nervous System / pathology* Technetium Tc 99m Sestamibi / diagnostic use Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
|
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Impact of acute propranolol administration on dobutamine-induced myocardial ischemia as evaluated by...
Next Document: Effects of fluvastatin on coronary atherosclerosis in patients with mild to moderate cholesterol ele...