Document Detail


Myocardial beta-adrenoceptor density one month after acute myocardial infarction predicts left ventricular volumes at six months.
MedLine Citation:
PMID:  12383568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether myocardial beta-adrenoceptor (beta-AR) downregulation precedes and predicts left ventricular (LV) dilation after acute myocardial infarction (AMI), we measured beta-AR density within four weeks of AMI and correlated it with serial measurements of LV volumes. BACKGROUND: Patients who develop heart failure following AMI have an increased sympathetic drive to the heart within the first four weeks after infarction. METHODS: We prospectively studied 61 patients in whom AMI was the first presentation of coronary artery disease (CAD) and with no signs of heart failure. The LV volumes were measured one, three, and six months after AMI by echocardiography. Beta-AR density was measured using positron emission tomography with S-[(11)C]CGP 12177. Seventeen matched healthy volunteers served as controls. RESULTS: Whole heart beta-AR density was lower in patients than in controls (6.25 +/- 0.98 pmol/g vs. 8.32 +/- 2.14 pmol/g, p < 0.0001). In patients, beta-AR density was inversely correlated with end-systolic and end-diastolic volumes six months after AMI. Patients whose LV was dilated at six months had a lower beta-AR density in noninfarcted myocardium than patients without dilation (6.15 pmol/g vs. 6.98 pmol/g, p = 0.008). In addition, beta-AR density in noninfarcted myocardium was higher when the infarct-related artery was patent (6.87 +/- 1.14 pmol/g vs. 5.76 +/- 0.86 pmol/g occluded, p < 0.01). CONCLUSIONS: Myocardial beta-AR density is reduced after AMI in the absence of heart failure, and the reduction predicts later LV dilation. These data are suggestive of an enhanced sympathetic drive to the heart, having an important etiologic role in LV remodeling after AMI.
Authors:
Nicos Spyrou; Stuart D Rosen; Farzin Fath-Ordoubadi; Rohan Jagathesan; Rodney Foale; Jaspal S Kooner; Paolo G Camici
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  40     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-17     Completed Date:  2002-11-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1216-24     Citation Subset:  AIM; IM    
Affiliation:
Medical Research Council Clinical Sciences Centre and National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Catecholamines / blood
Disease Progression
Down-Regulation*
Echocardiography
Female
Heart Failure / etiology
Humans
Hypertrophy, Left Ventricular / etiology*,  physiopathology
Male
Middle Aged
Myocardial Infarction / blood,  complications*,  pathology*,  therapy
Predictive Value of Tests
Prospective Studies
Receptors, Adrenergic, beta / analysis*,  genetics
Severity of Illness Index
Stroke Volume
Time Factors
Tomography, Emission-Computed
Treatment Outcome
Ventricular Function, Left
Ventricular Remodeling*
Chemical
Reg. No./Substance:
0/Catecholamines; 0/Receptors, Adrenergic, beta

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