Document Detail

Myocardial oxidative metabolic supply-demand relationships in patients with nonischemic dilated cardiomyopathy.
MedLine Citation:
PMID:  16919578     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Nonischemic dilated cardiomyopathy (NIDCM) is associated with left ventricular remodeling, hypertrophy, and mitochondrial metabolic abnormalities in vitro. We evaluated the hypothesis that energy supply, as judged by the rate of myocardial oxidative metabolism, is inadequate to meet oxygen demand in patients with NIDCM compared with normal subjects. METHODS AND RESULTS: We used positron emission tomography to determine the myocardial carbon 11 acetate decay rate (kmono) as an index of energy supply, and we compared kmono with the rate-pressure product (RPP) as an index of metabolic demand in 7 patients with NIDCM and 7 normal subjects. The mean kmono value (SEM) was 0.060 +/- 0.006 min(-1) in NIDCM patients versus 0.054 +/- 0.002 in normal subjects (P = not significant). The RPP was 9949 +/- 931 beats/ Hg in NIDCM patients and 6521 +/- 476 in normal subjects (P = .007). The relationship of kmono to this index of demand (kmono/RPP) was 6.2 x 10(-6) in NIDCM patients but was 8.5 x 10(-6) in normal subjects (P = .003). Thus RPP, as an index of myocardial oxygen demand, was poorly matched by the rate of oxidative metabolism in those patients with NIDCM. The kmono was closely related to RPP in normal subjects (r = 0.83, P = .02) but not in NIDCM patients. Furthermore, there was no significant relationship between kmono and wall stress as another index of oxygen demand. CONCLUSIONS: These results are consistent with a mitochondrial metabolic abnormality in heart failure. This metabolic mismatch detected by positron emission tomography may contribute to the pathophysiology of congestive heart failure and left ventricular remodeling.
Marvin W Kronenberg; Gerald I Cohen; Marlo F Leonen; Thomas A Mladsi; Marcelo F Di Carli
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  13     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-08-21     Completed Date:  2006-09-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  544-53     Citation Subset:  IM    
Division of Cardiology, Wayne State University School of Medicine, Detroit, Mich, USA.
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MeSH Terms
Cardiomyopathy, Dilated / complications,  metabolism*,  radionuclide imaging
Heart Ventricles / metabolism*
Metabolic Clearance Rate
Metabolic Diseases / metabolism*,  radionuclide imaging
Middle Aged
Myocardial Ischemia / complications,  metabolism,  radionuclide imaging
Myocardium / metabolism*
Oxygen / metabolism*
Oxygen Consumption*
Ventricular Dysfunction, Left / etiology,  metabolism*
Ventricular Remodeling
Reg. No./Substance:

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