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

1)用1.5Tesla磁共振系统对28例肥厚型心肌病(HCM)患者和7例正常对照的冠状动脉血流储备(CFR)进行了测定。在静脉注射潘生丁前后，在垂直于冠状静脉窦的倾斜成像平面上获得k空间分割的快速编码电影图像。将平均血流速度与血管横截面积的乘积进行积分，测量血流量。采集涵盖整个左心室的屏气电影磁共振图像以量化左心室质量。肥厚型心肌病组冠状动脉平均血流储备显著低于对照组(1.72±0.49 vs.3.01±0.75，p&lt；0.01)。2)心肌病仓鼠交感神经功能障碍和脂肪酸代谢异常的评估(Bio 14.6)。心肌病仓鼠同时给予I-123间碘苯基胍(MIBG)和I-123或I-125标记的β-甲基-碘苯基-十五烷酸(BMIPP)，并拍摄左室心肌放射自显影。结果表明：(1)心力衰竭心肌病仓鼠心肌脂肪酸代谢明显恶化。(2)肉眼可见交感神经功能障碍早于脂肪酸代谢异常的出现，但定量评估两种异常出现的时间无显著差异。

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.