Document Detail


Wall thickening at rest and contractile reserve early after myocardial infarction: correlation with myocardial perfusion and metabolism.
MedLine Citation:
PMID:  9285178     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Abnormalities in wall thickening and their reaction to stimulation can be studied by magnetic resonance imaging. OBJECTIVE: To analyse the relationship between these abnormalities and changes in myocardial perfusion and fatty acid metabolism. METHODS: Fifteen patients with a myocardial infarction underwent low-dose dobutamine magnetic resonance imaging to assess their wall thickening and contractile reserve, and technetium-99m sestamibi (MIBI) and beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) single-photon emission tomography to assess their myocardial perfusion and fatty acid uptake. For nine segments per patient, the wall thickening was scored as normal, hypokinetic or akinetic, and the myocardial perfusion as normal (> 65%), mildly to moderately reduced (35-65%) or severely reduced (< 35%). Abnormalities in fatty acid uptake were compared with the myocardial perfusion and defined as matched (difference < or = 10%) or mismatched (difference > 10%) reduction. RESULTS: Thirty-four segments had abnormal wall thickening (13 hypokinetic and 21 akinetic). The wall thickening at rest was significantly related to the uptake of MIBI (P < 0.001), but not to abnormalities in the uptake of BMIPP. All of the akinetic segments had an abnormal uptake of MIBI (15 severely and six mildly to moderately reduced), whereas 7 of 13 hypokinetic segments had a normal and five a midly to moderately reduced uptake. A significant relationship between abnormalities of fatty acid metabolism and the contractile reserve was also found (P < 0.002): 14 of 16 segments with and only six of 18 without contractile reserve had a mismatched reduction in uptakes of MIBI and BMIPP. CONCLUSION: This study confirms the relationship between the wall thickening at rest and the residual perfusion after infarction. On the other hand, the contractile reserve, which is an accepted indicator of the viability of the infarct region, is associated strongly with abnormalities of fatty acid metabolism.
Authors:
P Dendale; P R Franken; E E van der Wall; A de Roos
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Coronary artery disease     Volume:  8     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-10-23     Completed Date:  1997-10-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  259-64     Citation Subset:  IM    
Affiliation:
Department of Cardiology, AZVUB, Brussels, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiotonic Agents / diagnostic use
Coronary Circulation*
Dobutamine / diagnostic use
Evaluation Studies as Topic
Fatty Acids / diagnostic use,  metabolism
Female
Humans
Iodine Radioisotopes / diagnostic use
Iodobenzenes / diagnostic use
Magnetic Resonance Imaging
Male
Middle Aged
Myocardial Contraction*
Myocardial Infarction / pathology,  physiopathology*
Myocardium / pathology*
Radiopharmaceuticals / diagnostic use
Technetium Tc 99m Sestamibi / diagnostic use
Time Factors
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Fatty Acids; 0/Iodine Radioisotopes; 0/Iodobenzenes; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 116754-87-1/iodofiltic acid; 34368-04-2/Dobutamine

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


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