MYOCARDIAL BLOOD-FLOW RESPONSE TO PACING TACHYCARDIA AND TO DIPYRIDAMOLE INFUSION IN PATIENTS WITH DILATED CARDIOMYOPATHY WITHOUT OVERT HEART-FAILURE - A QUANTITATIVE ASSESSMENT BY POSITRON EMISSION TOMOGRAPHY
MYOCARDIAL BLOOD-FLOW RESPONSE TO PACING TACHYCARDIA AND TO DIPYRIDAMOLE INFUSION IN PATIENTS WITH DILATED CARDIOMYOPATHY WITHOUT OVERT HEART-FAILURE - A QUANTITATIVE ASSESSMENT BY POSITRON EMISSION TOMOGRAPHY
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DOI：
10.1161/01.cir.92.4.796
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发表时间：
1995-08-15
期刊：
影响因子：
37.8
通讯作者：
LABBATE, A
中科院分区：
文献类型：
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作者：
NEGLIA, D;PARODI, O;LABBATE, A
背景：晚期扩张型心肌病(DCM)存在心肌血流量(MBF)损害，这种病的血流动力学因素继发于严重的心功能不全，可限制心肌血流灌注。为探讨扩张型心肌病(DCM)患者是否存在独立于血流动力学因素的MBF损害，本研究旨在定量检测无明显心力衰竭的轻度疾病患者的心肌血流灌注。方法和结果22例DCM患者和13名健康受试者在静息状态、起搏诱发的心动过速和静脉滴注潘生丁(0.56 mg/kg，超过4min)后，用正电子发射断层扫描和N-13-氨水测定绝对局部MBF(毫升/分钟)。患者为纽约心脏协会功能I-II级，核素血管造影显示左心室射血分数下降(35+/-8%，范围21%-48%)，冠状动脉造影正常，左室舒张末压正常或中度升高(9.2+/-5.5 mm Hg，范围2-20 mm Hg)。在三种研究条件下，患者和对照组之间的动脉血压、心率和心率-压力乘积没有差异。与对照组相比，DCM患者静息时的平均MBF较低(0.80+/-0.25和1.08+/-0.20毫升)。分钟(-1)。G(-1)，P
Background Myocardial blood flow (MBF) impairment has been documented in advanced dilated cardiomyopathy (DCM) in which hemodynamic factors, secondary to severe ventricular dysfunction, may limit myocardial perfusion. To assess whether MBF impairment in DCM may also be present independent of hemodynamic factors, the present study was designed to quan tify myocardial perfusion in patients with mild disease without overt heart failure.Methods and Results Absolute regional MBF (milliliters per minute per gram) was measured by positron emission tomography and N-13-ammonia in resting conditions, during pacing-induced tachycardia, and after dipyridamole infusion (0.56 mg/kg over 4 minutes) in 22 DCM patients and in 13 healthy subjects. Patients were in New York Heart Association functional class I-II and showed depressed left ventricular (LV) ejection fraction by radionuclide angiography (35+/-8%; range, 21% to 48%), normal coronary angiography, and normal or moderately increased LV end-diastolic pressure (9.2+/-5.5 mm Hg; range, 2 to 20 mm Hg). There were no differences in arterial blood pressure, heart rate, and rate-pressure product between patients and control subjects in the three study conditions. Compared with control subjects, DCM patients had lower mean MBF at rest (0.80+/-0.25 versus 1.08+/-0.20 mL . min(-1). g(-1), P