Altered Myocardial Vasodilatation in Patients With Hypertriglyceridemia in Anatomically Normal Coronary Arteries

“…This observation in our study supports previous work by Yokoyama et al who reported that myocardial vasodilatation was reduced in patients with hypertriglyceridemia without overt coronary stenosis. 27 Previous reports have shown that MBF and MPR are affected not only by classical coronary risk factors, such as hypertension, dyslipidemia, and diabetes mellitus, 28-32 but also anemia, LVMI and renal dysfunction. 33-35 Inconsistent with earlier works, the present study indicates that fatty liver rather than diabetes mellitus, hypercholesterolemia and hypertension is strongly associated with reduced MPR.…”

Section: Discussionmentioning

confidence: 96%

Impaired Myocardial Perfusion Reserve in Patients With Fatty Liver Disease Assessed by Quantitative Myocardial Perfusion Magnetic Resonance Imaging

Nakamori

Onishi

Nakajima

et al. 2012

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp onalcoholic fatty liver disease (NAFLD) is a highly prevalent condition characterized by fatty infiltration of liver cells resembling that of alcohol-induced liver injury but occurring in patients who do not abuse alcohol. 1-3 For a long time, the presence of NAFLD was considered a benign condition with little or no clinical significance. 4 However, recent results indicate that individuals with NAFLD, even without metabolic syndrome (MetS), are at high risk for coronary artery disease (CAD) 5 and the severity of the liver histology in NAFLD patients is closely associated with intima-media thickness. 2,3,6,7 Furthermore, Villanova et al showed that NAFLD is a risk factor for endothelial dysfunction, by evaluating the flowmediated vasodilatation of the brachial artery. 8 This result has stimulated interest in a possible common pathway of disease progression between fatty liver and atherosclerosis. In a recent study evaluating NAFLD patients in Europe, abnormal coronary flow reserve was found in 42% of patients without clinical signs of CAD, by using transthoracic Doppler harmonic echocardiography. 9 However, no data are currently available regarding the relationship between fatty liver and altered myocardial perfusion reserve (MPR) in the Japanese population. First-pass contrast-enhanced myocardial perfusion magnetic resonance imaging (MRI) has emerged as a method of detecting the presence and measuring the extent of hypoperfusion caused by flow-limiting CAD. 10-16 Stress-rest perfusion MRI may also provide a more objective evaluation of altered MPR in subjects with flow-limiting CAD and of microcirculation dysfunction in patients without flow-limiting epicardial coronary artery stenosis, through quantitative evaluation of myocardial blood flow (MBF), and by analysis of the myocardial and blood signal intensity time curves. 17,18 Accordingly, the purpose of our study was to determine whether the presence of a fatty liver on abdominal computed tomography (CT) is associated with alteration of MPR in subjects without flow-limiting CAD Motonori Nagata, MD; Tairo Kurita, MD; Tomomi Yamada, PhD; Kakuya Kitagawa, MD; Kaoru Dohi, MD; Mashio Nakamura, MD; Hajime Sakuma, MD; Masaaki Ito, MDBackground: The purpose of this study was to determine whether the presence of fatty liver is associated with an alteration in myocardial perfusion reserve (MPR).

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“…Third, the plasma HDL-C level was significantly different between the 2 types of cardiomyopathies. The plasma levels of TC and TG have been reported to correlate with MFR, 11,12 but there is no evidence concerning the relationship between MFR and HDL-C. Finally, a comparison of patients with HCM and those with DHCM was not performed in this study, nor were serial changes of MFR from HCM to DHCM investigated.…”

Section: Study Limitationsmentioning

confidence: 90%

“…The first is epicardial coronary stenosis [1][2][3][4][5][6][7][8] and the second is disturbance of the microcirculation. [9][10][11][12][13][14] In this study, all patients underwent coronary angiography and the absence of angiographically significant coronary stenosis was verified. Therefore, the difference in impaired vasodilatation capacity may be related to functional differences in the microcirculation.…”

Section: Difference In the Impairment Of Vasodilatation Capacitymentioning

confidence: 98%

Difference in Myocardial Flow Reserve Between Patients With Dilated Cardiomyopathy and Those With Dilated Phase of Hypertrophic Cardiomyopathy Evaluation by 15O-Water PET

Ohba

Hosokawa

Kambara

et al. 2007

Circ J

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yocardial flow reserve (MFR) is defined as the ratio of maximal to basal myocardial blood flow (MBF), and it is related to the severity of coronary artery stenosis. [1][2][3][4][5][6][7][8] Therefore, the MFR value is clinically useful for decision-making and the strategy of coronary intervention. Recent studies have shown that MFR is impaired by age 9 and coronary risk factors, such as smoking, 10 hyperlipidemia (HPL), 11,12 diabetes mellitus (DM), 13 and hypertension (HTN), 14 even in the absence of coronary stenosis. The MFR can be accurately measured invasively and noninvasively. Clinical evaluation of MFR using positron emission tomography (PET) is a safe and repeatable method to use for patients without coronary artery disease, 15-17 compared with invasive methods such as Doppler flow-wire. 18 Several studies have reported that MFR is impaired, together with the poor prognosis, in both patients with dilated cardiomyopathy (DCM) [19][20][21][22][23][24] and those with hypertrophic cardiomyopathy (HCM). [25][26][27][28][29][30] In particular, the prognosis is poorer for patients with the dilated phase of HCM (DHCM), who have systolic dysfunction and left ventricular (LV) remodeling, than in those with DCM. However, the pathophysiological differences between these 2 types of cardiomyopathies remain unclear. The purpose of this study was to compare MBF, MFR and coronary vascular resistance (CVR) between patients with DCM and those with DHCM, using 15 O-labeled water PET,8,[31][32][33] which is similar to 13 N ammonia PET. 34 Methods Study PopulationWe studied 30 patients with cardiomyopathies (23 men, 7 women; mean age 60.9±12.3 years) who were admitted to the Department of Cardiovascular Medicine, Kyoto University Hospital because of worsening heart failure. The group included 23 patients with DCM (Group A) and 7 patients with DHCM (Group B). After admission, the patients were treated with conventional medical therapy, and Circ J 2007; 71: 884 -890 (Received October 10, 2006; revised manuscript received January 24, 2007; accepted February 26, 2007 (MFR) is impaired in patients with nonischemic cardiomyopathy, and the reduced MFR may be related to poor prognosis. Several studies report that the mortality rate for patients with DHCM is higher than for DCM, but the difference between these 2 cardiomyopathies is still unclear. The purpose of this study was to assess the MFR of these 2 cardiomyopathies, using 15 O-water positron emission tomography (PET) to elucidate their differences. Methods and ResultsIn total 30 patients were investigated: 23 with DCM (Group A) and 7 with DHCM (Group B). All those who were in a stable condition underwent cardiac catheterization. Myocardial blood flow (MBF) at rest and under ATP infusion was measured by 15 O-water PET, and the MFR was calculated. There were no significant differences in the hemodynamics of the 2 groups. The mean MFR in DHCM was significantly lower than that in DCM (1.49±0.31 vs 2.62±1.08; p=0.042), whereas MBF at rest did not differ (DCM vs DHCM: 0.66±0.20 ...

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Altered Myocardial Vasodilatation in Patients With Hypertriglyceridemia in Anatomically Normal Coronary Arteries

Cited by 35 publications

References 43 publications

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Impaired Myocardial Perfusion Reserve in Patients With Fatty Liver Disease Assessed by Quantitative Myocardial Perfusion Magnetic Resonance Imaging

Difference in Myocardial Flow Reserve Between Patients With Dilated Cardiomyopathy and Those With Dilated Phase of Hypertrophic Cardiomyopathy Evaluation by 15O-Water PET

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