Coronary flow reserve in patients with dilated cardiomyopathy

Inoue, Teruo; Sakai, Yoshihiko; Morooka, Shigenori; Hayashi, Terumi; Takayanagi, Kunio; Yamanaka, Tohru; Kakoi, Hideo; Takabatake, Yutaka

doi:10.1016/0002-8703(93)90061-d

Cited by 95 publications

(62 citation statements)

References 21 publications

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“…3,5 In fact, alterations in MVD without overt coronary stenosis have been indicated in a variety of conditions; for example, hypertrophic cardiomyopathy, 6 dilated cardiomyopathy, 7 and diabetes with and without associated hypertension, 8 -10 and in normal segments in patients with myocardial infarction. 11 We have reported a reduced MVD without overt coronary stenosis in patients with hypercholesterolemia.…”

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confidence: 99%

“…1 It has been shown that MVD can be altered without evidence of ischemia in hypercholesterolemics [2][3][4] and that there is a significant inverse relationship between MVD and plasma TG levels in hyperlipidemics without evidence of ischemia. 3,5 In fact, alterations in MVD without overt coronary stenosis have been indicated in a variety of conditions; for example, hypertrophic cardiomyopathy, 6 dilated cardiomyopathy, 7 and diabetes with and without associated hypertension, 8 -10 and in normal segments in patients with myocardial infarction. 11 We have reported a reduced MVD without overt coronary stenosis in patients with hypercholesterolemia.…”

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confidence: 99%

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

Yokoyama

Ohtake

Momomura

et al. 1998

ATVB

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Abstract-Reduced myocardial vasodilatation (MVD) in hypercholesterolemics without overt coronary stenosis has been reported.However, the status of MVD in hypertriglyceridemics has not yet been clarified. The aim of this study was to investigate whether MVD is impaired in patients with hypertriglyceridemia without overt coronary stenosis. Twenty-three hypertriglyceridemics (10 normocholesterolemic hypertriglyceridemics [HTGs] and 13 mixed combined hyperlipidemics [MCHLs]) and 13 age-matched controls were studied. All patients were proven to have more than one normal coronary artery, as diagnosed by coronary angiography, and those segments that were perfused by anatomically normal coronary arteries were used in the study. Myocardial blood flow (MBF) during dipyridamole (DP) loading and baseline MBF were measured by using positron emission tomography and [13 N]ammonia, after which MVD was calculated. Baseline MBF (mL ⅐ min Ϫ1 ⅐ 100 g Ϫ1) was comparable among HTG (76.0Ϯ26.1), MCHL (77.0Ϯ26.1), and controls (80.3Ϯ38.5). However, MBF during DP loading was significantly lower in MCHL (159Ϯ52.5) than in control subjects (292Ϯ166, PϽ.01), while it was comparable in HTG (202Ϯ104) and controls. MVD was significantly reduced in both HTG (2.70Ϯ1.09, PϽ.05) and MCHL (2.07Ϯ.70, PϽ.01) compared with controls (3.73Ϯ1.14). MVD in MCHLs tended to be reduced compared with that in HTGs, but the difference was statistically insignificant (Pϭ.08). There was a significant relationship between MVD and both plasma triglycerides (rϭϪ.47, PϽ.01) and plasma total cholesterol (rϭϪ.55, PϽ.01). When controls and HTGs were combined, the relationship between MVD and plasma total triglycerides became more prominent (rϭϪ.55, PϽ.05), and the significant relationship between cholesterol level and MVD disappeared. Multivariate regression analysis has revealed that the triglyceride level (Fϭ5.2, PϽ.05) was independently related to MVD (rϭ.69, PϽ.01). In conclusion, MVD was reduced in hypertriglyceridemics in anatomically normal coronary arteries. Hypertriglyceridemia is an independent factor for this abnormality. (Arterioscler Thromb Vasc Biol. 1998;18:294-299.) Key Words: hyperlipidemia Ⅲ hypertriglyceridemia Ⅲ atherosclerosis Ⅲ myocardial vasodilatation Ⅲ PET R educed MVD has been thought to be a factor in coronary stenosis.1 It has been shown that MVD can be altered without evidence of ischemia in hypercholesterolemics 2-4 and that there is a significant inverse relationship between MVD and plasma TG levels in hyperlipidemics without evidence of ischemia. 3,5 In fact, alterations in MVD without overt coronary stenosis have been indicated in a variety of conditions; for example, hypertrophic cardiomyopathy, 6 dilated cardiomyopathy, 7 and diabetes with and without associated hypertension, 8 -10 and in normal segments in patients with myocardial infarction. 11 We have reported a reduced MVD without overt coronary stenosis in patients with hypercholesterolemia. 12However, most recent studies, including our own, involved patients with pure hyperchole...

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confidence: 99%

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

Yokoyama

Ohtake

Momomura

et al. 1998

ATVB

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“…Though all the patients were treated with the same treatment it wasn't completely explained why the level of some patients' RDW is high and that of their CFR's is low. Studies suggest that oxidative stress might be involved in the pathogenetic processes in heart failure and myocardial oxidative stress and inflammation increase in hypertrophied or failing myocardium (30)(31)(32). Red blood cells (have a huge antioxidant capacity and serve as a primary oxidative sink, but they are prone to oxidative damage, which reduces cell survival and induces the release of immature erythrocytes into circulation (33).…”

Section: Discussionmentioning

confidence: 99%

Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy

Özülkü¹,

Çalışkan²,

Güllü³

et al. 2014

Anadolu Kardiyol Derg

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Objective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value ≥2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p: 0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.

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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 in patients with dilated cardiomyopathy

Cited by 95 publications

References 21 publications

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

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

Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy

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

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