TY - JOUR
T1 - Cardiac sympathetic dysfunction correlates with abnormal myocardial contractile reserve in dilated cardiomyopathy patients
AU - Ohshima, Satoru
AU - Isobe, Satoshi
AU - Izawa, Hideo
AU - Nanasato, Mamoru
AU - Ando, Akitada
AU - Yamada, Akira
AU - Yamada, Kiyoyasu
AU - Kato, Tomoko S.
AU - Obata, Koji
AU - Noda, Akiko
AU - Nishizawa, Takao
AU - Kato, Katsuhiko
AU - Nagata, Kohzo
AU - Okumura, Kenji
AU - Murohara, Toyoaki
AU - Yokota, Mitsuhiro
PY - 2005/12/6
Y1 - 2005/12/6
N2 - OBJECTIVES: We investigated the relationship between iodine-123- metaiodobenzylguanidine (123I-MIBG) findings and myocardial contractile reserve in patients with mild to moderate dilated cardiomyopathy (DCM). BACKGROUND: Little is known regarding the relationship between cardiac sympathetic nervous function and myocardial contractile reserve in DCM. METHODS: Twenty-four DCM patients who showed sinus rhythm underwent echocardiography, biventricular catheterization, and myocardial 123I-MIBG scintigraphy. Left ventricular (LV) pressures were measured using a micromanometer-tipped catheter. The myocardial contractile function (LV dP/dtmax) was determined at rest and during atrial pacing. The messenger ribonucleic acid (mRNA) expressions of intracellular Ca2+-regulatory proteins were analyzed by real-time quantitative reverse transcription-polymerase chain reaction. Myocardial 123I-MIBG accumulation was quantified as a heart-mediastinum ratio (HMR). RESULTS: A significant correlation was observed between the delayed 123I-MIBG HMR and the percentage change in LV dP/dtmax from the baseline to the peak or critical heart rate (r = 0.64; p < 0.001). The delayed 123I-MIBG HMR was significantly lower in patients showing a worsening change in LV dP/dtmax than in those showing a favorable change (p < 0.005). The maximum LV dP/dt max during pacing and the sarcoplasmic reticulum Ca 2+-ATPase (SERCA2) mRNA levels were significantly more reduced in patients with a delayed HMR ≤1.8 than in those with a delayed HMR >1.8 (p < 0.05, respectively). CONCLUSIONS: Abnormal myocardial 123I-MIBG accumulation is related to an impaired myocardial contractile reserve and down-regulation of SERCA2 mRNA in DCM. Myocardial 123I-MIBG scintigraphy can be useful in noninvasively evaluating myocardial contractile reserve in patients with mild to moderate DCM.
AB - OBJECTIVES: We investigated the relationship between iodine-123- metaiodobenzylguanidine (123I-MIBG) findings and myocardial contractile reserve in patients with mild to moderate dilated cardiomyopathy (DCM). BACKGROUND: Little is known regarding the relationship between cardiac sympathetic nervous function and myocardial contractile reserve in DCM. METHODS: Twenty-four DCM patients who showed sinus rhythm underwent echocardiography, biventricular catheterization, and myocardial 123I-MIBG scintigraphy. Left ventricular (LV) pressures were measured using a micromanometer-tipped catheter. The myocardial contractile function (LV dP/dtmax) was determined at rest and during atrial pacing. The messenger ribonucleic acid (mRNA) expressions of intracellular Ca2+-regulatory proteins were analyzed by real-time quantitative reverse transcription-polymerase chain reaction. Myocardial 123I-MIBG accumulation was quantified as a heart-mediastinum ratio (HMR). RESULTS: A significant correlation was observed between the delayed 123I-MIBG HMR and the percentage change in LV dP/dtmax from the baseline to the peak or critical heart rate (r = 0.64; p < 0.001). The delayed 123I-MIBG HMR was significantly lower in patients showing a worsening change in LV dP/dtmax than in those showing a favorable change (p < 0.005). The maximum LV dP/dt max during pacing and the sarcoplasmic reticulum Ca 2+-ATPase (SERCA2) mRNA levels were significantly more reduced in patients with a delayed HMR ≤1.8 than in those with a delayed HMR >1.8 (p < 0.05, respectively). CONCLUSIONS: Abnormal myocardial 123I-MIBG accumulation is related to an impaired myocardial contractile reserve and down-regulation of SERCA2 mRNA in DCM. Myocardial 123I-MIBG scintigraphy can be useful in noninvasively evaluating myocardial contractile reserve in patients with mild to moderate DCM.
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U2 - 10.1016/j.jacc.2005.08.046
DO - 10.1016/j.jacc.2005.08.046
M3 - Article
C2 - 16325043
AN - SCOPUS:28244446239
SN - 0735-1097
VL - 46
SP - 2061
EP - 2068
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 11
ER -