Document Detail


Effect of repeated episodes of reversible myocardial ischemia on myocardial blood flow and function in humans.
MedLine Citation:
PMID:  11959621     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nine patients with coronary artery disease and normal left ventricular (LV) function underwent two episodes of dobutamine-induced ischemia to determine whether repeated episodes of ischemia lead to cumulative stunning. Positron emission tomography (PET) and oxygen 15-labeled H(2)O was used to assess myocardial blood flow (MBF) at baseline, peak stress, and after stress for each ischemic episode. Quantitative echocardiographic assessment of global ejection fraction (EF) and regional systolic function (SF) was performed at rest and regular intervals after dobutamine. SF was assessed for regions subtended by a coronary artery with a >70% diameter stenosis. Both EF and SF were more severely impaired 45 min after the second episode of stress compared with 45 min after the first (both P < 0.01), despite no difference in duration of the two dobutamine infusions or MBF at peak stress (1.72 vs. 1.69). After both episodes of ischemia, when LV function was impaired but subsequently recovered, MBF (1.15 +/- 0.39 and 1.20 +/- 0.43, respectively) was no different to baseline MBF (1.02 +/- 0.35), confirming that repeated episodes of dobutamine-induced ischemia lead to cumulative myocardial stunning.
Authors:
Edward Barnes; David P Dutka; Masood Khan; Paolo G Camici; Roger J Hall
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  282     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-04-17     Completed Date:  2002-05-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1603-8     Citation Subset:  IM    
Affiliation:
Division of Cardiology and Medical Research Council, National Heart and Lung Institute, Faculty of Medicine, Imperial College of Science, Technology and Medicine, Hammersmith Hospital, London, United Kingdom. ebarnes@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity
Coronary Circulation
Coronary Disease / physiopathology
Dobutamine / diagnostic use
Echocardiography, Stress
Exercise
Female
Heart / physiopathology*
Humans
Male
Middle Aged
Myocardial Ischemia / complications,  etiology,  physiopathology*
Myocardial Stunning / etiology
Oxygen Radioisotopes
Recurrence
Tomography, Emission-Computed
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Oxygen Radioisotopes; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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