Coronary flow reserve correlates left ventricular diastolic dysfunction in patients with dilated cardiomyopathy

Teragaki, Masakazu; Yanagi, Shiro; Toda, Iku; Sakamoto, Kazuo; Hirota, Kazuyoshi; Takeuchi, Kazuhide; Yoshikawa, Junichi

doi:10.1002/ccd.10349

Cited by 14 publications

(14 citation statements)

References 33 publications

(50 reference statements)

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“…This result agrees with data from Weissmuller et al [20], who found no correlation between rate-pressure product and MBF at rest in patients with heart failure. Left ventricular enddiastolic pressure has been associated with myocardial flow reserve in other studies that examined their relation [22,24,25]. Our study showed no correlation between MBF at rest and left ventricular end-diastolic pressure, but there was significant negative correlation between MBF during hyperemia and left ventricular end-diastolic pressure.…”

Section: Discussionsupporting

confidence: 40%

Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by ¹⁵O–H₂O positron emission tomography

et al. 2011

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Although myocardial flow reserve (MFR) in congestive heart failure (CHF) has been reported to be impaired, the mechanism has not been fully shown in humans. Therefore, we performed positron emission tomography to measure myocardial blood flow (MBF) in patients with CHF and compared it with hemodynamic parameters. Sixteen normal coronary patients with CHF and ten normal controls were enrolled. 15 O-labeled water positron emission tomography was performed at rest and during peak hyperemia induced by adenosine triphosphate. MFR was calculated as the ratio of peak hyperemic to baseline MBF. All CHF patients underwent cardiac catheterization. Baseline MBF was similar between CHF patients and normal controls (0.73 ± 0.25 vs. 0.80 ± 0.12 mL/min/g, p = NS). Hyperemic MBF was significantly reduced in CHF patients than in controls (1.68 ± 1.09 vs. 3.21 ± 0.69 mL/min/g, p < 0.05). therefore, MFR was significantly reduced in CHF patients than in controls (2.30 ± 1.30 vs. 4.03 ± 0.90, p < 0.05). There was no significant correlation between baseline MBF and either pulmonary capillary wedge pressure or left ventricular end-diastolic pressure, while both hyperemic MBF and MFR significantly correlated with both pulmonary capillary wedge pressure (r = )0.67 and r = )0.75, respectively) and left ventricular end-diastolic pressure (r = )0.51 and r = )0.60, respectively). Despite elevated preload, MBF at rest in CHF patients was compensated to the similar level as that in controls. However, this compensation may exhaust vasodilatory reserve in the failing human heart. Thus, preload at rest is a determinant of myocardial vasodilator reserve and preload reduction may ameliorate coronary vasodilator response in CHF patients.

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Section: Discussionsupporting

confidence: 40%

Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by ¹⁵O–H₂O positron emission tomography

et al. 2011

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“…CFR has been demonstrated as a sensitive marker for patient outcome, with echocardiographic studies demonstrating that preserved CFR in the right coronary artery (RCA) predict a favourable patient outcome [74], whereas an impaired or reduced CFR is a predictor of dysfunction and worse patient outcome [74,75]. Although little work has been completed to look at the effect of CFR on the RV function, studies have demonstrated links between impaired CFR and LV diastolic dysfunction [76][77][78]. Galderisi et al [79] demonstrated that decreased CFR is associated with impaired relaxation and increased filling pressures; thus, reduced CFR is independent of LV geometry and preload.…”

Section: Coronary Flow Reservementioning

confidence: 99%

RV diastolic dysfunction: time to re-evaluate its importance in heart failure

et al. 2015

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Right ventricular (RV) diastolic dysfunction was first reported as an indicator for the assessment of ventricular dysfunction in heart failure a little over two decades ago. However, the underlying mechanisms and precise role of RV diastolic dysfunction in heart failure remain poorly described. Complexities in the structure and function of the RV make the detailed assessment of the contractile performance challenging when compared to its left ventricular (LV) counterpart. LV dysfunction is known to directly affect patient outcome in heart failure. As such, the focus has therefore been on LV function. Nevertheless, a strategy for the diagnosis and assessment of RV diastolic dysfunction has not been established. Here, we review the different causal mechanisms underlying RV diastolic dysfunction, summarising the current assessment techniques used in a clinical environment. Finally, we explore the role of load-independent indices of RV contractility, derived from the conductance technique, to fully interrogate the RV and expand our knowledge and understanding of RV diastolic dysfunction. Accurate assessment of RV contractility may yield further important prognostic information that will benefit patients with diastolic heart failure.

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“…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). In all these studies, it has been demonstrated that coronary flow reserve is reduced in DCM patients.…”

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 flow reserve correlates left ventricular diastolic dysfunction in patients with dilated cardiomyopathy

Cited by 14 publications

References 33 publications

Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by ¹⁵O–H₂O positron emission tomography

Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by ¹⁵O–H₂O positron emission tomography

RV diastolic dysfunction: time to re-evaluate its importance in heart failure

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

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Coronary flow reserve correlates left ventricular diastolic dysfunction in patients with dilated cardiomyopathy

Cited by 14 publications

References 33 publications

Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by 15O–H2O positron emission tomography

Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by 15O–H2O positron emission tomography

RV diastolic dysfunction: time to re-evaluate its importance in heart failure

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

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Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by ¹⁵O–H₂O positron emission tomography

Direct demonstration of preload dependency of myocardial flow reserve in human failing heart by ¹⁵O–H₂O positron emission tomography