Cardiac sympathetic dysfunction correlates with abnormal myocardial contractile reserve in dilated cardiomyopathy patients

Satoru Ohshima, Satoshi Isobe, Hideo Izawa, Mamoru Nanasato, Akitada Ando, Akira Yamada, Kiyoyasu Yamada, Tomoko S. Kato, Koji Obata, Akiko Noda, Takao Nishizawa, Katsuhiko Kato, Kohzo Nagata, Kenji Okumura, Toyoaki Murohara, Mitsuhiro Yokota

研究成果: Article査読

31 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)2061-2068
ページ数8
ジャーナルJournal of the American College of Cardiology
46
11
DOI
出版ステータスPublished - 06-12-2005
外部発表はい

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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