Document Detail


Residual coronary reserve identifies segmental viability in patients with wall motion abnormalities.
MedLine Citation:
PMID:  7608433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to determine whether the presence of residual coronary reserve can in itself identify viable segments. BACKGROUND: Experimental data suggest that despite hypoperfusion at rest, viable myocardium may exhibit persistence of coronary reserve. Preliminary observations in patients show that in basally dyssynergic areas, a residual vasodilator capability is present despite hypoperfusion at rest and that a flow-mediated increase in regional wall motion identifies residual viability. METHODS: Fourteen patients with evidence of previous myocardial infarction, infarct-related single-vessel coronary artery disease and impaired regional ventricular function at rest underwent positron emission viability imaging by fluorine-18 deoxyglucose. In addition, blood flow at rest and vasodilator capability were regionally evaluated in all patients by means of nitrogen-13 ammonia. RESULTS: Of a total of 252 segments, 133 were dyssynergic at rest. Of these 133 segments, 60 (group 1) showed normal metabolic activity and only mild reduction in myocardial blood flow. The other 73 segments showed a marked reduction in flow; of these, 25 (group 2, viable) had persistent metabolic activity, whereas 48 (group 3, necrotic) did not. Despite similar levels of hypoperfusion at rest, group 2 segments showed a preserved coronary reserve that was virtually absent in necrotic segments (2.6 +/- 1.3 vs. 1.3 +/- 0.5, p < 0.01). This value was similar to that observed in viable group 1 segments (2.5 +/- 1.6, p = NS). CONCLUSIONS: In addition to characterizing myocardium at risk, imaging of coronary flow at baseline and after dipyridamole by positron emission tomography provides helpful information on myocardial viability that may integrate the "static" viability information obtained with the baseline flow/metabolic approach.
Authors:
P Marzullo; O Parodi; G Sambuceti; A Giorgetti; E Picano; A Gimelli; P Salvadori; A L'Abbate
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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:  26     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-08-17     Completed Date:  1995-08-17     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  342-50     Citation Subset:  AIM; IM    
Affiliation:
CNR Institute of Clinical Physiology, Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Ammonia / diagnostic use
Coronary Angiography
Coronary Circulation / drug effects,  physiology*
Coronary Disease / diagnosis*,  physiopathology
Deoxyglucose / analogs & derivatives,  diagnostic use
Dipyridamole / diagnostic use
Echocardiography
Female
Fluorine Radioisotopes / diagnostic use
Fluorodeoxyglucose F18
Heart / drug effects,  physiopathology*,  radiography
Humans
Male
Middle Aged
Myocardium / metabolism
Nitrogen Radioisotopes / diagnostic use
Tomography, Emission-Computed
Chemical
Reg. No./Substance:
0/Fluorine Radioisotopes; 0/Nitrogen Radioisotopes; 154-17-6/Deoxyglucose; 58-32-2/Dipyridamole; 63503-12-8/Fluorodeoxyglucose F18; 7664-41-7/Ammonia

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


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