Mischa T Rijnierse1, Cornelis P Allaart1, Stefan de Haan1, Hendrik J Harms2, Marc C Huisman2, LiNa Wu1, Aernout M Beek1, Adriaan A Lammertsma2, Albert C van Rossum1, Paul Knaapen3. 1. Department of Cardiology, VU University Medical Center, De Boelelaan 1117, PO Box 7057, Amsterdam, HV 1081, The Netherlands Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands. 2. Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Cardiology, VU University Medical Center, De Boelelaan 1117, PO Box 7057, Amsterdam, HV 1081, The Netherlands Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands p.knaapen@vumc.nl.
Abstract
AIMS: Sympathetic denervation typically occurs in the infarcted myocardium and is associated with sudden cardiac death. Impaired innervation was also demonstrated in non-infarcted myocardium in ischaemic and dilated cardiomyopathy (ICMP and DCMP). Factors affecting sympathetic nerve integrity in remote myocardium are unknown. Perfusion abnormalities, even in the absence of epicardial coronary artery disease, may relate to sympathetic dysfunction. This study was aimed to assess the interrelations of myocardial blood flow (MBF), contractile function, and sympathetic innervation in non-infarcted remote myocardium. METHODS AND RESULTS: Seventy patients with ICMP or DCMP and LVEF ≤35% were included. [(15)O]H2O- and [(11)C]hydroxyephedrine (HED) PET was performed to quantify resting MBF, hyperaemic MBF, and sympathetic innervation. Cardiovascular magnetic resonance (CMR) imaging was performed to assess left ventricular function, mass, wall thickening, and scar size. Wall thickening, [(11)C]HED retention index (RI), and MBF were assessed in remote segments without scar, selected on CMR. [(11)C]HED RI was correlated with resting MBF (r = 0.41, P < 0.001) and hyperaemic MBF (r = 0.55, P < 0.001) in remote myocardium in both ICMP and DCMP. In addition, LV volumes (r = -0.40, P = 0.001), LV mass (r = -0.31, P = 0.008), and wall thickening (r = 0.45, P < 0.001) correlated with remote [(11)C]HED RI. Multivariable analysis revealed that hyperaemic MBF (B = 0.79, P < 0.001), wall thickening (B = 0.01, P = 0.03), and LVEDV (B = -0.03, P = 0.02) were independent predictors for remote [(11)C]HED RI. CONCLUSION: Hyperaemic MBF is independently associated with sympathetic innervation in non-infarcted remote myocardium in patients with ICMP and DCMP. This suggests that microvascular dysfunction might be an important factor related to sympathetic nerve integrity. Whether impaired hyperaemic MBF is the primary cause of this relation remains unclear. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Sympathetic denervation typically occurs in the infarcted myocardium and is associated with sudden cardiac death. Impaired innervation was also demonstrated in non-infarcted myocardium in ischaemic and dilated cardiomyopathy (ICMP and DCMP). Factors affecting sympathetic nerve integrity in remote myocardium are unknown. Perfusion abnormalities, even in the absence of epicardial coronary artery disease, may relate to sympathetic dysfunction. This study was aimed to assess the interrelations of myocardial blood flow (MBF), contractile function, and sympathetic innervation in non-infarcted remote myocardium. METHODS AND RESULTS: Seventy patients with ICMP or DCMP and LVEF ≤35% were included. [(15)O]H2O- and [(11)C]hydroxyephedrine (HED) PET was performed to quantify resting MBF, hyperaemic MBF, and sympathetic innervation. Cardiovascular magnetic resonance (CMR) imaging was performed to assess left ventricular function, mass, wall thickening, and scar size. Wall thickening, [(11)C]HED retention index (RI), and MBF were assessed in remote segments without scar, selected on CMR. [(11)C]HED RI was correlated with resting MBF (r = 0.41, P < 0.001) and hyperaemic MBF (r = 0.55, P < 0.001) in remote myocardium in both ICMP and DCMP. In addition, LV volumes (r = -0.40, P = 0.001), LV mass (r = -0.31, P = 0.008), and wall thickening (r = 0.45, P < 0.001) correlated with remote [(11)C]HED RI. Multivariable analysis revealed that hyperaemic MBF (B = 0.79, P < 0.001), wall thickening (B = 0.01, P = 0.03), and LVEDV (B = -0.03, P = 0.02) were independent predictors for remote [(11)C]HED RI. CONCLUSION: Hyperaemic MBF is independently associated with sympathetic innervation in non-infarcted remote myocardium in patients with ICMP and DCMP. This suggests that microvascular dysfunction might be an important factor related to sympathetic nerve integrity. Whether impaired hyperaemic MBF is the primary cause of this relation remains unclear. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Daniel Juneau; Fernanda Erthal; Benjamin J W Chow; Calum Redpath; Terrence D Ruddy; Juhani Knuuti; Rob S Beanlands Journal: J Nucl Cardiol Date: 2016-07-28 Impact factor: 5.952
Authors: Attila Kiss; Ping Wu; Michaela Schlederer; Patrick M Pilz; Petra Lujza Szabo; Jingle Li; Lukas Weber; Chrysoula Vraka; Verena Pichler; Markus Mitterhauser; Xiaoli Zhang; Karin Zins; Dietmar Abraham; Sijin Li; Bruno K Podesser; Marcus Hacker; Xiang Li Journal: Basic Res Cardiol Date: 2022-08-25 Impact factor: 12.416
Authors: Tong Wang; Kai Yi Wu; Robert C Miner; Jennifer M Renaud; Rob S B Beanlands; Robert A deKemp Journal: EJNMMI Res Date: 2018-07-20 Impact factor: 3.138