POSITRON TOMOGRAPHY IN ISCHEMIC HEART DISEASE

简介(摘自申请者摘要)：本研究建议 应用13N测量心肌血流量(MBF) 有冠状动脉危险因素但无冠状动脉病变患者的血氨和正电子发射计算机断层扫描 动脉疾病以检测冠状动脉的非侵入性改变 血管反应性作为冠状动脉演化早期的可能事件 动脉硬化。具体地说，它将用腺苷测试总积分 冠脉血管舒缩功能，更具体地说，通过MBF对 冷加压试验对以内皮依赖性为主的冠状动脉 血管反应性。过去和初步的观察结果支持这一可行性。 这种探索冠状动脉血管运动的方法。基于宠物的测量结果是 本研究的独特之处，因为需要以绝对单位测量MBF 这在两种类型的更传统的方法中是不可能的 患者，一个患有胰岛素抵抗和II型糖尿病，另一个 有冠心病危险因素的绝经后妇女。在糖尿病患者中 申请者还将通过EBCT来确定冠状动脉钙化评分 以比较血管运动功能的变化和结构的变化 以及它们的时间依赖级数以及是否可能的级数 II型糖尿病的胰岛素抵抗是否可以被证实 严格的抗糖尿病控制可能与降脂相结合可以 延缓这一进程。对于绝经后的妇女，申请者将 探索雌激素的保护作用，并检查这种作用是否 被孕激素及其不同形式否定或修饰，进一步，是否 适当的保护需要添加他汀类药物和抗氧化剂。如果 如果观察成功，可能会为更大的前景奠定基础 临床试验，最重要的是，提供了对早期 动脉粥样硬化的形成过程以及对其有益影响的可能性 进步。

DESCRIPTION (Adapted from Applicants Abstract): The research proposed in this application employs measurements of myocardial blood flow (MBF) with 13N ammonia and PET in patients with coronary risk factors but without coronary artery disease in order to detect noninvasive alterations in coronary vasoreactivity as likely events early in the evolution of coronary atherosclerosis. Specifically, it will test with adenosine the total integrated coronary vasomotor function and, more specifically, through responses of MBF to cold pressor testing the predominantly endothelial dependent coronary vasoreactivity. The past and preliminary observations support the feasibility of this approach for exploring coronary vasomotion. PET based measurements are unique to this study because MBF measurements in absolute units are required which are not possible with more conventional approaches in two types of patients, one with insulin resistance and Type-II-Diabetes and a second one of postmenopausal women with coronary risk factors. In the diabetic patients the applicants will also determine coronary artery calcium scores with EBCT in order to compare alterations in vasomotor function and structural changes as well as their time dependent progression and whether the possible progression of insulin resistance to Type-II-Diabetes can be demonstrated and whether rigorous anti-diabetic control possibly in conjunction with lipid lowering can retard this progression. In the postmenopausal women, the applicants will explore protective effects of estrogens and examine whether this effect is negated or modified by progestins and its different forms and further, whether adequate protection requires addition of statins and anti-oxidants. If successful, the observation could lay the foundation for larger prospective clinical trials and, most importantly, provide new insights into the early atherogenic process as well as possibilities to beneficially influence its progression.