The chane of coronary flow reserve in hypertrophic and dilated cardiomyopathy and the relation with arious myocardial pathology

1)应用1.5T磁共振成像系统对28例肥厚型心肌病（HCM）患者和7例正常人进行冠状动脉血流储备（CFR）测定。在静脉注射潘生丁前后，在垂直于冠状窦的倾斜成像平面上获得快速速度编码电影MR图像，并进行k空间分割。将平均流速和血管横截面积的乘积积分以测量血流量。采集包含整个左心室的屏气电影MR图像以量化左心室质量。肥厚型心肌病患者冠脉血流储备明显低于对照组（1.72±0.49比3.01±0.75，P<0.01）。HCM患者的冠状动脉血流储备降低，2）心肌病仓鼠交感神经功能障碍和脂肪酸代谢异常的评价心肌病仓鼠被给予I-123间碘苄基胍（MIBG）和I-123或I-125标记的β-甲基-碘苯基-十五烷酸（BMIPP）。同时拍摄左心室心肌放射自显影。交感神经功能障碍和脂肪酸代谢异常通过获得的放射自显影的视觉和定量评估来评价。(1)心肌病心力衰竭仓鼠心肌脂肪酸代谢恶化。(2)结果表明，视觉评估显示交感神经功能障碍早于脂肪酸代谢异常的出现，而定量评估显示两者的出现时间无显著性差异。

1) Assessment of coronary flow reserve in patients with hypertrophic cardiomyopathy (HCM) using MRICoronary flow reserve (CFR) was measured in 28 patients with HCM and 7 normal controls using 1.5 Tesla MR system. Fast velocity encoded cine MR images with k space segmentation were obtained in an oblique imaging plane perpendicular to the coronary sinus before and after intravenous injection of dipyridamole. The products of mean velocity and cross-sectional area of the vessel were integrated to measure blood flow. Breath-hold cine MR images encompassing the entire left ventricle were acquired to quantify the left ventricular mass. Mean coronary flow reserve in patients with HCM was significantly lower than that of the controls (1.72±0.49 vs. 3.01±0.75, p<0.01). In patients with HCM, the coronary flow reserve was decreased, even though there was no abnormality in cardiac function.2) Assessment of sympathetic nerve dysfunction and abnormal fatty acid metabolism in cardiomyopathic hamster (Bio 14.6).Cardiomyopathic hamsters were administered with I-123 meta-iodobenzyl-guanidine (MIBG) and I-123 or I-125 labeled beta-metyl-iodophenyl-pentadecanoic acid (BMIPP) simultaneously and autoradiograms of the left ventricular myocardium were obtained. The sympathetic nerve dysfunction and abnormality in fatty acid metabolism was evaluated by the visual and quantitative assessment of the autoradiograms obtained.(1) Myocardial fatty acid metabolism was deteriorated in cardiomyopathic hamster with cardiac failure.(2) It was resulted that the sympathetic nerve dysfunction appeared earlier than the appearance of abnormal fatty acid metabolism by visual assessment However, there was no significant difference in the appearance time between the two abnormalities by the quantitative assessment.