Myocardial fatty-acid, glucose, and total oxidative metabolism in patients with myocardial infarction and left ventricular remodeling

心肌梗死患者心肌脂肪酸、葡萄糖和总氧化代谢与左心室重构

• 批准号: 15591293
• 负责人: OHTE Nobuyuki
• 金额: $ 2.18万
• 依托单位: Nagoya City University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15591293/
• 关键词: myocardial oxidative metabolism; Myocardial fatty-acid metabolism; ^<11>C-acetate; ^<11>C-palmitate; Myocardial infarction; Left ventricular remodeling; C-11-palmitate; 左室リモデリング

In patients with acute myocardial infarction (MI), alteration of metabolism sources is observed on left ventricular (LV) wall and LV remodeling is provoked in remote normal region in sub-acute and/or chronic phases, being related to the patients' prognosis. Accordingly, we investigated the relationships between myocardial blood flow, myocardial fatty-acid metabolism, and myocardial total oxidative metabolism in patients with MI in sub-acute phase. Furthermore, we also studied the myocardial oxidative activity in remote normal region in patients with MI and LV remodeling in chronic stage.1)We investigated myocardial fatty acid metabolism from the viewpoint of palmitate beta-oxidation using positron emission tomography (PET). The clearance rate constant of ^<11>C-acetate (acetate-Kmono) and that of ^<11>C-palmitate (palmitate-Kmono) from myocardium were calculated using a monoexponential equation in 14 patients with MI. Regional relative myocardial blood flow calculated from the initial … More distribution of ^<11>C-acetate and left ventricular (LV) wall motion were also evaluated. Maintained myocardial fatty acid beta-oxidation with better myocardial blood flow is substantial for preserving total myocardial oxidative metabolism and LV wall motion in patients with MI. The finding whether the early-phase clearance of ^<11>C-palmitate is fitted with a monoexponential curve may provide important information in the evaluation of myocardial fatty acid beta-oxidation.2)In 8 patients with MI with diabetes mellitus (DM), 10 with MI without DM, and 6 healthy volunteers, we studied the oxidative metabolism as the clearance rate constant (Kmono) of ^<11>C-acetate in remote normal region using PET. All patients with MI had single vessel coronary artery disease. Apparent LV remodeling was observed in patient with MI. Kmono in remote normal region in patients MI was significantly decreased compared with the Kmono in normal volunteers, which was obtained as a mean value of all ROIs on the LV wall. This impaired myocardial oxidative metabolism in remote normal region with LV remodeling indicates that the myocardium in such a region is not normal but damaged, and it is considered to be one of the reasons for poor prognosis of the patients having LV remodeling after MI. No significant difference was observed in Kmono in remote normal region between the patient with DM and those without DM Less

急性心肌梗死（MI）患者在亚急性期和/或慢性期，左室壁代谢源发生改变，在较远的正常区域引起左室重构，与患者的预后有关。因此，我们研究了心肌梗死患者亚急性期心肌血流量、心肌脂肪酸代谢和心肌总氧化代谢之间的关系。此外，我们还研究了MI和慢性期左室重构患者远端正常区域的心肌氧化活性。1）我们使用正电子发射断层扫描（PET）从棕榈酸β-氧化的角度研究了心肌脂肪酸代谢。用<11><11>单指数方程计算了14例心肌梗死患者心肌中~（13）C-乙酸盐（acetate-Kmono）和~（13）C-棕榈酸盐（palmitate-Kmono）的清除速率常数。根据初始心肌血流量计算的局部相对心肌血流量 ...更多信息 还<11>评价了14 C-乙酸盐的分布和左心室（LV）壁运动。维持心肌脂肪酸β-氧化和更好的心肌血流量对于心肌梗死患者的总心肌氧化代谢和左室壁运动具有重要意义。（<11>2）应用PET技术对8例MI合并糖尿病（DM）、10例MI不伴DM患者和6例健康志愿者的心肌脂肪酸β-氧化代谢进行了研究，以清除率常数（Kmono）<11>为指标。所有MI患者均为单支冠状动脉病变。MI患者中观察到明显的LV重构。MI患者远端正常区域的Kmono与正常志愿者的Kmono相比显著降低，Kmono作为左室壁所有ROI的平均值获得。这种伴有左室重构的远端正常区域的心肌氧化代谢受损表明该区域的心肌不正常而受损，这被认为是MI后左室重构患者预后不良的原因之一。糖尿病患者与非糖尿病患者远端正常区Kmono无显著性差异。

项目成果

Tl-201 washout rate in remote normal regions in patients with prior myocardial infarction and left ventricular remodeling.

既往有心肌梗死和左心室重构的患者中远端正常区域的 Tl-201 洗脱率。

• 发表时间: 2005
• 期刊: Journal of Nuclear Cardiology 12・2
• 作者: Miyabe Hiromichi;Goto Toshihiko
• 通讯作者: Goto Toshihiko

Evaluation of fatty acid beta-oxidation in patients with prior myocardial infarction in relation to myocardial blood flow, total oxidative metabolism, and left ventricular wall motion.

评估既往心肌梗死患者的脂肪酸β-氧化与心肌血流量、总氧化代谢和左心室壁运动的关系。

• 发表时间: 2005
• 期刊: Circulation Journal 69・12
• 作者: Miyabe Hiromichi

Evaluation of whole left ventricular systolic performance and local myocardial systolic function in patients with prior myocardial infarction using global long-axis myocardial strain.

使用整体长轴心肌应变评估既往心肌梗死患者的整个左心室收缩性能和局部心肌收缩功能。

• 发表时间: 2004
• 期刊: American Journal of Cardiology 94・7
• 作者: Goto Toshihiko;Ohte Nobuyuki;Miyabe Hiromichi;Mukai Seiji;Sakata Seiichiro;Hayano Junichiro;Kimura Genjiro.;Nobuyuki Ohte
• 通讯作者: Nobuyuki Ohte