TY - JOUR
T1 - Delineation of myocardial stunning and hibernation by positron emission tomography in advanced coronary artery disease
AU - Conversano, Andrea
AU - Walsh, John F.
AU - Geltman, Edward M.
AU - Perez, Julio E.
AU - Bergmann, Steven R.
AU - Gropler, Robert J.
N1 - Funding Information:
From the ~Division of Nuclear Medicine, Edward Mallinckrodt Institute of Radiology, and the bCardiovascular Division, Department of Internal Medicine, Washington University School of Medicine. Supported in part by a grant from the Edward Mallinckrodt, Jr., Foundation, St. Louis, Missouri, and by NIH grants HL17646 (SCOR in Coronary and Vascular Diseases) and HL13851. The study was performed during Dr. Gropler's tenure as a Clinician-Scientist Awardee from the American Heart Association. Received for publication June 30, 1995; accepted Aug. 21, 1995. Reprint requests: Robert J. Gropler, MD, Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, 510 South Kingshighway Boulevard, St. Louis, Me. 63110. Copyright © 1996 by Mosby-Year Book, Inc. 0002-8703/96/$5.00 + 0 4/1/69511
PY - 1996
Y1 - 1996
N2 - With positron emission tomography, the resting flow abnormalities underlying reversible left ventricular dysfunction in 17 patients with chronic coronary artery disease were delineated. The level of flow in reversibly dysfunctional segments (i.e, those demonstrating improvement after revascularization) was markedly variable, ranging from 0.32 to 1.25 ml/gm/min. In 20 of these segments, flow was preserved, whereas in 12 segments, flow was reduced, when compared with that in, age-matched controls. Preservation of flow was associated with preservation of myocardial oxygen consumption and no alterations in myocardial substrate use. In contrast, a reduction in flow resulted in a decrease myocardial oxygen consumption and an increase in myocardial glucose use. Thus resting reversible left ventricular dysfunction in patients with chronic coronary artery disease can reflect a diversity of resting flow abnormalities. Moreover, myocardial perfusion at rest is frequently within normal limits, suggesting that the reversible mechanical dysfunction in these patients is attributable to intermittent myocardial stunning and not hibernation.
AB - With positron emission tomography, the resting flow abnormalities underlying reversible left ventricular dysfunction in 17 patients with chronic coronary artery disease were delineated. The level of flow in reversibly dysfunctional segments (i.e, those demonstrating improvement after revascularization) was markedly variable, ranging from 0.32 to 1.25 ml/gm/min. In 20 of these segments, flow was preserved, whereas in 12 segments, flow was reduced, when compared with that in, age-matched controls. Preservation of flow was associated with preservation of myocardial oxygen consumption and no alterations in myocardial substrate use. In contrast, a reduction in flow resulted in a decrease myocardial oxygen consumption and an increase in myocardial glucose use. Thus resting reversible left ventricular dysfunction in patients with chronic coronary artery disease can reflect a diversity of resting flow abnormalities. Moreover, myocardial perfusion at rest is frequently within normal limits, suggesting that the reversible mechanical dysfunction in these patients is attributable to intermittent myocardial stunning and not hibernation.
UR - http://www.scopus.com/inward/record.url?scp=0030003791&partnerID=8YFLogxK
U2 - 10.1016/S0002-8703(96)90521-9
DO - 10.1016/S0002-8703(96)90521-9
M3 - Article
C2 - 8604622
AN - SCOPUS:0030003791
SN - 0002-8703
VL - 131
SP - 440
EP - 450
JO - American heart journal
JF - American heart journal
IS - 3
ER -