Document Detail


Impact of endothelial dysfunction on left ventricular remodeling after successful primary coronary angioplasty for acute myocardial infarction--analysis by quantitative ECG-gated SPECT--.
MedLine Citation:
PMID:  16485576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We hypothesized that endothelial cell integrity in the risk area would influence left ventricular remodeling after acute myocardial infarction. PATIENTS AND METHODS: Twenty patients (61 +/- 8 y.o.) with acute myocardial infarction underwent 99mTc-tetrofosmin imaging in the subacute phase and three months after successful primary angioplasty due to myocardial infarction. All patients were administered angiotensin-converting enzyme inhibitor after revascularization. Cardiac scintigraphies with quantitative gated SPECT were performed at the sub-acute stage and again 3 months after revascularization to evaluate left ventricular (LV) remodeling. The left ventricular ejection fraction (EF) and end-systolic and end-diastolic volume (ESV, EDV) were determined using a quantitative gated SPECT (QGS) program. Three months after myocardial infarction, all patients underwent cardiac catheterization examination with coronary endothelial function testing. Bradykinin (BK) (0.2, 0.6, 2.0 microg/min) was administered via the left coronary artery in a stepwise manner. Coronary blood flow was evaluated by Doppler flow velocity measurement. Patients were divided into two groups by BK-response: a preserved endothelial function group (n = 10) and endothelial dysfunction group (n = 10). RESULTS: At baseline, both global function and LV systolic and diastolic volumes were similar in both groups. However, LV ejection fraction was significantly improved in the preserved-endothelial function group, compared with that in the endothelial dysfunction group (42 +/- 10% to 48 +/- 9%, versus 41 +/- 4% to 42 +/- 13%, p < 0.05). LV volumes progressively increased in the endothelial dysfunction group compared to the preserved-endothelial, function group (123 +/- 45 ml to 128 +/- 43 ml, versus 111 +/- 47 ml to 109 +/- 49 ml, p < 0.05). CONCLUSION: In re-perfused acute myocardial infarction, endothelial function within the risk area plays an important role with left ventricular remodeling after myocardial infarction.
Authors:
Shinro Matsuo; Ichiro Nakae; Tetsuya Matsumoto; Minoru Horie
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  20     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-02-20     Completed Date:  2006-03-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  57-62     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Japan.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Endothelium, Vascular / radionuclide imaging*
Female
Gated Blood-Pool Imaging / methods*
Humans
Image Interpretation, Computer-Assisted / methods
Male
Middle Aged
Myocardial Infarction / complications,  radionuclide imaging*,  therapy*
Prognosis
Tomography, Emission-Computed, Single-Photon / methods*
Treatment Outcome
Ventricular Dysfunction, Left / etiology,  prevention & control*,  radionuclide imaging*

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


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