Metabolic changes in hibernating myocardium after percutaneous transluminal coronary angioplasty and the relation between recovery in left ventricular function and free fatty acid metabolism

Shimonagata, Tsuyoshi; Nanto, Shinsuke; Kusuoka, Hideo; Ohara, Takahiro; Inoue, K; Yamada, Setsuko; Nishimura, Yoshiko; Matsubara, Noboru; Hori, Masatsugu; Nishimura, Tsunehiko; Kubori, Shujiro

doi:10.1016/s0002-9149(98)00399-3

Cited by 15 publications

(6 citation statements)

References 18 publications

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“…Myocardial 201 Tl and 123 I-BMIPP dual scintigraphy enable simultaneous assessment of myocardial flow and fatty acid metabolism [11]. The areas exhibiting a flow-metabolism mismatch, defined as a larger defect on 123 I-BMIPP than that on 201 Tl, correspond to impaired but viable myocardium after AMI [12,13], and are considered to be where further improvements in myocardial function will be [14][15][16][17]. On the other hand, AMI patients showing a concordant defect on 201 Tl/ 123 I-BMIPP dual single-photon emission computed tomography (SPECT) have a worse outcome than those without it [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial 201 Tl and 123 I-BMIPP dual SPECT findings

Mori

Isobe

Sakai

et al. 2015

European Journal of Radiology

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Section: Introductionmentioning

confidence: 99%

Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial 201 Tl and 123 I-BMIPP dual SPECT findings

Mori

Isobe

Sakai

et al. 2015

European Journal of Radiology

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“…[8][9][10][11] This also reflects a state brought about by continuing fatty acid metabolism impairment mainly due to persistent myocardial ischemia or memory imaging. 9,11) It has been suggested that these mechanisms are due to severe culprit lesions and infarct-related artery occlusion or stenosis, and a sustained tissuelevel perfusion injury and impaired myocardial reperfusion of the microvascular level in patients with no significant coronary artery stenosis.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between the Mismatch of 123I-BMIPP and 201Tl Myocardial Single-Photon Emission Computed Tomography and Autonomic Nervous System Activity in Patients With Acute Myocardial Infarction

et al. 2006

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SUMMARYThe purpose of this study was to elucidate the relationship between the mismatch of thallium-201(Tl) and iodine-123-beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) myocardial single-photon emission computed tomography (SPECT) and autonomic nervous system activity in myocardial infarction (MI) patients. The subjects were 40 patients (34 males, 6 females) who underwent examinations by 123 I-BMIPP and 201 Tl myocardial SPECT imaging and 24-hour Holter monitoring within a 3-day period 3 weeks after the onset of their first MI. R-R intervals were analyzed every hour over a period of 24 hours by fast Fourier transformation (FFT). High frequency (HF) and low frequency (LF) were defined as markers of cardiac vagal activity in the former and the LF/HF ratio as sympathetic activity. Greater or more extensive decreases in the BMIPP image than that in the Tl image were defined as a positive mismatch. Patients were divided into positive and negative mismatch groups of 20 patients each.There were no significant differences between the 2 groups in age, sex, site of infarction, max CK (creatine kinase), max CK-MB, or left ventricular ejection fraction. The incidences of clinical signs suggesting residual myocardial ischemia were significantly greater in the positive than in the negative mismatch group (P < 0.05). The mean values for HF over the entire 24-hour period and over the 5-hour nocturnal period (0-5 AM) in the positive mismatch group were both significantly lower than those in the negative mismatch group (P < 0.001 in both groups). The 24-hour mean HF and mean nighttime HF in patients with signs of residual ischemia were both significantly lower than in those without signs of residual ischemia in the positive mismatch group (P < 0.05 in both groups).The mean LF/HF ratio for both the entire 24-hour and the nocturnal period in the positive mismatch group were significantly higher than those in the negative mismatch group (P < 0.001, P < 0.05, respectively). The daily profile of hourly HF measurements was significantly lower in the positive mismatch group than in the negative mismatch group (P < 0.02). The mean values of HF for 24-hour and 5-hour periods were significantly lower in patients with signs of residual ischemia in the positive mismatch group than in those with signs of residual ischemia in the negative mismatch group (P < 0.01, P < 0.02, respectively). There were no significant differences between the patients with From the

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“…The importance of this approach, using exogenous short chain fatty acids to bypass LCFA utilization, 13 is that if a direct measure of LCFA were performed, we would only demonstrate the known reduction in LCFA oxidation. [1][2][3] The novelty of these findings is that by using a short chain fatty acid, we have elucidated a continued oxidation of fatty acids that would otherwise not be detected with labeled LCFA. The indication that butyrate contributions increased during ischemia in this study may be the result of inhibition of LCFA oxidation through CPT1, as suggested by previous work on the regulation of LCFA oxidation through malonyl CoA sensitivity in mitochondria from ischemic dog hearts.…”

Section: Discussionmentioning

confidence: 99%

“…Reduced long chain fatty acid (LCFA) oxidation in ischemic but viable human hearts has also been reported. 2,3 However, oxidation of fuels within the mitochondria of the hypoperfused myocardium has not been examined with substrates that bypass the highly regulated transfer of LCFA into the mitochondrial matrix. The current protocol tests the oxidative capability of mitochondria in the in vivo heart during restricted blood flow.…”

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confidence: 99%

Mitochondrial Preference for Short Chain Fatty Acid Oxidation During Coronary Artery Constriction

et al. 2002

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Background-Reduced fatty acid oxidation in hypoperfused myocardium is believed to result from impaired oxidation in mitochondria. This study suggests another mechanism, that oxidative capacity exceeds regulated entry of long chain fatty acid (LCFA). The ability of myocardium to oxidize fatty acids and metabolize glucose during stenosis was examined in open chest, anesthetized pigs. Methods and Results-The left anterior descending (LAD) coronary artery was infused for 40 minutes (5 mL/min LAD) with [2-13 C] butyrate (4 mmol/L), a short chain fatty acid (SCFA), plus [2-13 C] glucose (10 mmol/L) in either nonischemic controls (nϭ4) or at the end of 5 hours of LAD flow reduction (40%, nϭ7). With LAD constriction, left ventricular wall thickening fell 45Ϯ8% (PϽ0.01). Despite glycolytic production of lactate and alanine, hypoperfused myocardium preferentially oxidized SCFA over endogenous LCFA. SCFA accounted for 63Ϯ4% (meanϮSEM) of carbon units entering oxidation in both ischemic epicardium and endocardium versus only 38Ϯ4% and 40Ϯ6% in respective samples from normal myocardium (PϽ0.002). Unexpectedly, SCFA contributions were elevated in both endocardium and epicardium despite preserved epicardial blood flow versus a 58Ϯ9% drop in endocardial flow (PϽ0.05). No significant oxidation of glucose was evident, indicating that unlabeled fuels were primarily LCFA. Conclusions-Because SCFA bypass LCFA transport into mitochondria, during LAD constriction, mitochondrial capacity to oxidize fatty acid exceeds LCFA entry for oxidation. Importantly, metabolic changes were disassociated from transmural tissue perfusion.

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Metabolic changes in hibernating myocardium after percutaneous transluminal coronary angioplasty and the relation between recovery in left ventricular function and free fatty acid metabolism

Cited by 15 publications

References 18 publications

Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial 201 Tl and 123 I-BMIPP dual SPECT findings

Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial 201 Tl and 123 I-BMIPP dual SPECT findings

Relationship Between the Mismatch of 123I-BMIPP and 201Tl Myocardial Single-Photon Emission Computed Tomography and Autonomic Nervous System Activity in Patients With Acute Myocardial Infarction

Mitochondrial Preference for Short Chain Fatty Acid Oxidation During Coronary Artery Constriction

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