Quantification of regional myocardial blood flow using 13N-ammonia and reoriented dynamic positron emission tomographic imaging.

Kuhle, William; Porenta, Gerold; Huang, Sung‐Cheng; Buxton, Denis B.; Gambhir, Sanjiv S.; Hansen, Herbert; Phelps, Michael E.; Schelbert, Heinrich R.

doi:10.1161/01.cir.86.3.1004

Cited by 210 publications

(99 citation statements)

References 15 publications

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“…25 Corrections for dead time, attenuation, and scatter were applied, and the images were reconstructed to an effective inplane resolution of 7-mm FWHM using a Hanning filter. All subjects refrained from taking caffeinecontaining food and beverages for at least 18 h prior to the scanning.…”

Section: Positron Emission Tomographymentioning

confidence: 99%

Association between vascular dysfunction and reduced myocardial flow reserve in patients with hypertension: a LIFE substudy

et al. 2004

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Impaired myocardial flow reserve (MFR) has been demonstrated in hypertension, and has been associated with peripheral vascular changes. We investigated whether MFR was impaired and associated with structural and/or functional vascular changes in hypertensive patients without evidence of coronary artery disease (CAD). We measured left ventricular (LV) mass index by echocardiography and MFR by positron emission tomography in 33 unmedicated, hypertensive patients with electrocardiographic LV hypertrophy without CAD, and 15 age-and gender-matched normotensive subjects. We also measured 24-h ambulatory blood pressure, minimal forearm vascular resistance (MFVR) by plethysmography, media:lumen ratio in isolated, subcutaneous resistance arteries by myography, intima-media crosssectional area of the common carotid artery, and flow-mediated (FMD) and nitroglycerin-induced dilatation (NID) of the brachial artery by ultrasound. Compared to the controls, the patients had impaired MFR (2.4 (95% CI 1.95-2.8) vs 3.4 (2.7-4.2), Po0.01) due to increased resting myocardial blood flow (MBF) (0.82 (0.73-0.91) vs 0.65 (0.56-0.75) ml/g min), and decreased dipyridamole-stimulated MBF (1.80 (1.55-2.1) vs 2.3 (1.80-2.8) ml/g min, both Po0.05). The difference in resting MBF disappeared (80 (74-87) vs 86 (74-97) ll/ kg mmHg, NS) when normalized for blood pressure and heart rate. MFR correlated negatively to median 24-h systolic blood pressure (r ¼ À0.50, Po0.01) as well as to LV mass index (r ¼ À0.45, Po0.05) and MFVR in men (r ¼ À0.47, Po0.05), and positively to FMD (r ¼ 0.44, Po0.05) and NID (r ¼ 0.40, Po0.05). Hypertensive patients with electrocardiographic LV hypertrophy without CAD had impaired MFR associated with cardiovascular hypertrophy and vasodilatory dysfunction. This suggests that MFR is impaired by LV hypertrophy and structural/functional vascular damage in the coronary and noncoronary circulation.

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Section: Positron Emission Tomographymentioning

confidence: 99%

Association between vascular dysfunction and reduced myocardial flow reserve in patients with hypertension: a LIFE substudy

et al. 2004

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“…13,14 The time activity curve of the left ventricular cavity was used as an input function. The tracer spillover was corrected by least-squares nonlinear regression analysis on our program to calculate MBF, with the assumption that myocardial and left ventricular radioactivity were influenced by each other.…”

Section: Determination Of Mbfmentioning

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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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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“…15,16 The effects of TEA on myocardial blood flow during sympathetic stimulation and pharmacological vasodilation may therefore be evaluated in patients with ischemic heart disease.…”

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confidence: 99%

Effects of High Thoracic Epidural Analgesia on Myocardial Blood Flow in Patients With Ischemic Heart Disease

et al. 2005

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Background-In patients with ischemic heart disease, high thoracic epidural analgesia (TEA) has been proposed to improve abnormalities of coronary function by inhibiting cardiac sympathetic tone. We evaluated the effect of TEA on myocardial blood flow in patients with ischemic heart disease. Methods and Results-Twenty male patients with multivessel ischemic heart disease were studied. An epidural catheter was inserted between the second and third thoracic vertebral interspace (Th2 to Th3). Analgesia was induced by epidural injection of bupivacaine 0.5%, and a sensory block from the sixth cervical (C6 to C7) to Th10 (Th8 to Th11) vertebral interspace was achieved. Myocardial blood flow was measured with dynamic 13 N-ammonia PET with and without TEA at rest, during pharmacological vasodilation with dipyridamole, and during sympathetic stimulation with the cold pressor test. Myocardial blood flow during dipyridamole increased similarly, regardless of TEA, in all regions except in myocardium subtended by collateral arteries in which blood flow increased more with than without TEA (PϽ0.05). Without TEA, myocardial blood flow during the cold pressor test remained unchanged compared with myocardial blood flow at rest. In contrast, with TEA, myocardial blood flow increased in all vascular territories. Coronary vascular resistance increased during the cold pressor test without TEA, whereas with TEA, coronary resistance decreased in myocardium subtended by nonstenotic and stenotic coronary vessels and remained unchanged in myocardium subtended by occluded vessels. Conclusions-In patients with multivessel ischemic heart disease, TEA partly normalizes the myocardial blood flow response to sympathetic stimulation.

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Quantification of regional myocardial blood flow using 13N-ammonia and reoriented dynamic positron emission tomographic imaging.

Cited by 210 publications

References 15 publications

Association between vascular dysfunction and reduced myocardial flow reserve in patients with hypertension: a LIFE substudy

Association between vascular dysfunction and reduced myocardial flow reserve in patients with hypertension: a LIFE substudy

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

Effects of High Thoracic Epidural Analgesia on Myocardial Blood Flow in Patients With Ischemic Heart Disease

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