Coronary dilatory capacity in idiopathic dilated cardiomyopathy: Analysis of 16 patients

Opherk, D; Schwarz, Franz; Mall, Gerhard; Manthey, J; Baller, D.; Kübler, W.

doi:10.1016/0002-9149(83)90205-9

Cited by 123 publications

(46 citation statements)

References 20 publications

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“…39 In contrast to those findings, changes in the small arteries were absent in patients with DCM. 22 Although myocardial biopsy was not performed in all patients in the present study, because of procedural risk, the difference in the MFR between these 2 types of cardiomyopathies may be attributed to dysfunction of the intra-myocardial small arteries. Also, this study demonstrated that the MFR in the septum was lower than that in the free wall in patients with DHCM, though the septal MFR was higher than in that of the free wall in patients with DCM.…”

Section: Difference In the Impairment Of Vasodilatation Capacitymentioning

confidence: 84%

“…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.…”

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confidence: 99%

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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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Section: Difference In the Impairment Of Vasodilatation Capacitymentioning

confidence: 84%

mentioning

confidence: 99%

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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“…Results showed a depressed MBF of 0.45F0.15 [30] and of 0.49F0.17 ml/ min/g [29], a normal flow of 0.78F0.17 ml/min/g [31] and a high normal flow of 1.02F0.21 ml/min/g [21]. This great variability was probably due to the different methods used and different states of the disease.…”

Section: Characterization Of Global Mvo 2 and Mbf In Dcm Patientsmentioning

confidence: 96%

“…Measurements of MBF in nonischemic DCM have been performed with microspheres [29], with 13 N-ammonia [21], or inert gas washout techniques [30,31]. Results showed a depressed MBF of 0.45F0.15 [30] and of 0.49F0.17 ml/ min/g [29], a normal flow of 0.78F0.17 ml/min/g [31] and a high normal flow of 1.02F0.21 ml/min/g [21].…”

Section: Characterization Of Global Mvo 2 and Mbf In Dcm Patientsmentioning

confidence: 99%

Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block

Lindner

Vogt

Baller

et al. 2005

European Journal of Heart Failure

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Objective: In patients with dilated cardiomyopathy (DCM), left bundle branch block (LBBB) is a common finding. The characteristic feature is an asynchronous septal wall motion and most frequently a delay of the lateral and/or posterior wall segments. With the onset of cardiac resynchronization therapy, there is a focus on the specific pathophysiology of a LBBB. However, quantitative data on regional myocardial oxygen consumption (MVO 2 ) and blood flow (MBF) are missing. Methods: We studied 31 patients with severe DCM and LBBB (ejection fraction 22.1F7.1%) and 14 patients with mild to moderate DCM without LBBB (ejection fraction 46.7F7.9%). Global and regional MVO 2 as well as MBF were determined from a dynamic 11 C-acetate positron emission tomography (PET) study. Results: Global MVO 2 and MBF were lower in the DCM group with LBBB than in the control group ( Pb0.05). Regionally, the LBBB group revealed a higher ( Pb0.05) MVO 2 and MBF in the lateral wall than in the other walls. The control group did not show significant differences between the myocardial walls and demonstrated a smaller variability of the parameters. Conclusion: DCM patients with LBBB exhibit a more heterogeneous distribution of MVO 2 and MBF among the myocardial walls than DCM patients without LBBB. Due to the LBBB associated electromechanical alterations, the highest regional values of MVO 2 and MBF are found in the lateral wall.

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“…Impairment of coronary flow reserve has been shown in patients with dilated cardiomyopathy (DCM) despite normal epicardial coronary arteries (1)(2)(3)(4)(5). Various methods have been used to measure coronary flow in these patients, including coronary sinus thermodilution (3,6), intracoronary Doppler flow wire (7)(8)(9), position emission tomography (PET) (10,11), and transesophageal echocardiography (12).…”

Section: Introductionmentioning

confidence: 99%

Assessment of coronary blood flow in non-ischemic dilated cardiomyopathy with the TIMI frame count method

Yaşar¹,

Bilen²,

Yüksel³

et al. 2010

Anadolu Kardiyol Derg

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Assessment of coronary blood flow in non-ischemic dilated cardiomyopathy with the TIMI frame count method Methods: This retrospective study included 62 patients with idiopathic dilated cardiomyopathy (34 men, 28 women; mean age 59.7±10.6 years) and 62 control subjects without dilated cardiomyopathy (28 men, 34 women; mean age 56.6±9.8 years). All patients and control subjects had angiographically proven normal coronary arteries. Dilated cardiomyopathy patients had a left ventricular ejection fraction <45%. The TIMI frame count was determined for each major coronary artery in each patient. Statistical analysis was performed using Student's t test, Chi-square test and Pearson correlation analysis.Results: The TIMI frame counts for each major epicardial coronary artery were found to be significantly higher in patients with idiopathic dilated cardiomyopathy compared to control subjects (corrected TIMI frame count for left anterior descending coronary artery: 37.0±12.5 vs 28.7±11.6, respectively, p<0.001; left circumflex coronary artery: 37.7±12.1 vs 31.0±12.5, respectively, p=0.003; right coronary artery: 37.4±12.6 vs 30.7±11.6, respectively, p=0.003). Mean TIMI frame count had significant although weak positive correlation with left ventricular end-diastolic diameter (r=0.350, p<0.001) and left ventricular end-systolic diameter (r=0.358, p<0.001). Conclusion:We have shown that patients with idiopathic dilated cardiomyopathy and angiographically normal coronary arteries have higher TIMI frame counts for all three coronary vessels, indicating impaired coronary blood flow, compared to control subjects without dilated cardiomyopathy. (Anadolu Kardiyol Derg 2010 December 1; 10(6): 514-8)

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Coronary dilatory capacity in idiopathic dilated cardiomyopathy: Analysis of 16 patients

Cited by 123 publications

References 20 publications

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

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

Global and regional myocardial oxygen consumption and blood flow in severe cardiomyopathy with left bundle branch block

Assessment of coronary blood flow in non-ischemic dilated cardiomyopathy with the TIMI frame count method

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