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  • 1
    Electronic Resource
    Electronic Resource
    Glucose metabolism in relation to perfusion in patients with ischaemic heart disease (1994)
    Springer
    European journal of nuclear medicine 21 (1994), S. 292-296 
    Details
    ISSN: 1619-7089
    Keywords: Glucose metabolism ; Myocardial perfusion ; Positron emission tomography ; Myocardial viability ; Ischaemic heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to correlate myocardial perfusion and residual metabolism in patients with coronary artery disease, the regional metabolic rate of glucose (rMRGlu) was compared with regional perfusion under glucose loading state (GL) and fasting state (FA). Fluorine-18 deoxyglucose dynamic scan was obtained in ten patients after oral GL and in 16 patients under FA. rMRGlu in seven segments was calculated using Patlak graphic analysis for comparison with normalized percent uptake of nitrogen-13 ammonia at rest in each segment. When perfusion was less than 45%, no segment showed an increase in rMRGlu (≥0.3 pmol/min/g) under either FA (0/6 segments) or GL (0/8 segments), indicating a certain threshold of perfusion for maintenance of glucose metabolism. When perfusion exceeded 45%, rMRGlu was higher in GL (0.37±0.18 pmol/min/g) than FA (0.15±0.12 pmoVmin/g,P 〈 0.001) but there was very wide scatter of rMRGlu values under both states. Thus, both myocardium with preserved and myocardium with reduced glucose metabolism may exist when the perfusion exceeds 45%. In conclusion, a minimum threshold of perfusion for the maintenance of glucose metabolism may exist under both FA and GL. Below the threshold, irreversible damage may occur in the myocardium. Above the threshold, quantitative analysis of glucose metabolism should play an important role in differentiating reversibly injured myocardium from necrotic myocardium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00947963
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  • 2
    Electronic Resource
    Electronic Resource
    Prognostic value of iodine-123 labelled BMIPP fatty acid analogue imaging in patients with myocardial infarction (1996)
    Springer
    European journal of nuclear medicine 23 (1996), S. 272-279 
    Details
    ISSN: 1619-7089
    Keywords: Single-photon emission tomography ; Myocardial infarction ; Prognosis ; Iodine-123 fatty acid ; Thallium-201
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was undertaken to evaluate the prognostic value of iodine-123 labelled 15-iodophenyl3-R,S-methyl pentadecanoic acid (BMIPP) imaging in patients with myocardial infarction. BMIPP is an iodinated methyl branched fatty acid analogue which is trapped in the myocardium with little washout, thereby reflecting fatty acid utilization in the myocardium. We previously reported that in patients with myocardial infarction, regions are often observed where reduced BMIPP uptake is seen relative to thallium-201 perfusion at rest. However, the clinical significance of such discordant BMIPP uptake remains unknown. Fifty consecutive patients with chronic myocardial infarction referred for stress thallium scan and coronary arteriography underwent BMIPP imaging at rest. Each patient was in a stable condition at the time of the radionuclide study. Follow-up was performed at a mean interval of 23 months to investigate the prognostic implications of the radionuclide studies. Nine patients had cardiac events during the follow-up period. Univariate analysis showed that the number of discordant BMIPP versus201TL uptake segments was the best predictor of future cardiac events (P=0.0245), followed by the presence of discordant BMIPP uptake (P=0.0388) and the number of201TL redistribution segments (P=0.0444). When all the clinical and radionuclide variables were analysed by Cox regression analysis, the presence of discordant BMIPP uptake was the best, and an independent, predictor of future cardiac events (χ2=8.5) followed by the number of coronary stenoses on angiography (χ2=3.9). These preliminary data suggest that decreased BMIPP uptake relative to201TL is a valuable predictor of future cardiac events in patients with myocardial infarction. Areas with such discordant BMIPP uptake may contain jeopardized myocardium where fatty acid utilization has been severely suppressed relative to myocardial perfusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00837625
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  • 3
    Electronic Resource
    Electronic Resource
    Oxidative metabolism in the myocardium in normal subjects during dobutamine infusion (1993)
    Springer
    European journal of nuclear medicine 20 (1993), S. 231-237 
    Details
    ISSN: 1619-7089
    Keywords: Positron emission tomography ; Carbon-11 acetate ; Myocardial metabolism ; Dobutamine ; Oxygen consumption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To assess the biventricular response of the clearance rate of carbon-11 acetate as an index of myocardial oxidative metabolism to increase in work-load, dynamic positron emission tomography was performed at rest and during dobutamine infusion in 14 normal subjects. The clearance rate constant (Kmono) of the left ventricular (LV) myocardium increased during dobutamine infusion (0.112±0.020 min−1 vs 0.065±0.015 min−1 at rest) (P〈0.001) in proportion to the increase in the pressure-rate product. Kmono in the right ventricular (RV) myocardium also increased (0.080±0.018 min−1 vs 0.034±0.013 min−1 at rest) (P〈0.001), with an excellent correlation with the LV Kmono (r=0.920). The fact that the increase in RV Kmono during dobutamine infusion was greater (158%±81%) than that in LV Kmono (79%±39%) (P 〈 0.005) indicates a greater increase in oxidative metabolism in the RV in response to inotropic stimulation in normal subjects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00170004
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  • 4
    Electronic Resource
    Electronic Resource
    Glucose metabolism in relation to perfusion in patients with ischaemic heart disease (1994)
    Springer
    European journal of nuclear medicine 21 (1994), S. 292-296 
    Details
    ISSN: 1619-7089
    Keywords: Glucose metabolism ; Myocardial perfusion ; Positron emission tomography ; Myocardial viability ; Ischaemic heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to correlate myocardial perfusion and residual metabolism in patients with coronary artery disease, the regional metabolic rate of glucose (rMRGlu) was compared with regional perfusion under glucose loading state (GL) and fasting state (FA). Fluorine-18 deoxyglucose dynamic scan was obtained in ten patients after oral GL and in 16 patients under FA. rMRGlu in seven segments was calculated using Patlak graphic analysis for comparison with normalized percent uptake of nitrogen-13 ammonia at rest in each segment. When perfusion was less than 45%, no segment showed an increase in rMRGlu (≥0.3 pmol/min/g) under either FA (0/6 segments) or GL (0/8 segments), indicating a certain threshold of perfusion for maintenance of glucose metabolism. When perfusion exceeded 45%, rMRGlu was higher in GL (0.37±0.18 pmol/min/g) than FA (0.15±0.12 pmoVmin/g, P 〈 0.001) but there was very wide scatter of rMRGlu values under both states. Thus, both myocardium with preserved and myocardium with reduced glucose metabolism may exist when the perfusion exceeds 45%. In conclusion, a minimum threshold of perfusion for the maintenance of glucose metabolism may exist under both FA and GL. Below the threshold, irreversible damage may occur in the myocardium. Above the threshold, quantitative analysis of glucose metabolism should play an important role in differentiating reversibly injured myocardium from necrotic myocardium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00176567
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  • 5
    Electronic Resource
    Electronic Resource
    Myocardial ischemia enhances the expression of acidic fibroblast growth factor in human pericardial fluid (2000)
    Springer
    Heart and vessels 15 (2000), S. 112-116 
    Details
    ISSN: 1615-2573
    Keywords: Key words Collateral circulation ; Growth factor ; Ischemia ; Myocyte ; Reperfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acidic fibroblast growth factor (FGF) is a potent mitogen that can induce angiogenesis in vivo. We have recently reported a marked increase of basic FGF in the pericardial fluid of patients with severe coronary stenosis and an increase in vascular endothelial growth factor (VEGF) in the pericardial fluid of patients with severe myocardial ischemia. The purpose of this study was to evaluate whether acidic FGF levels in the pericardial fluid are associated with severe myocardial ischemia. Immediately after incision of the pericardium in 48 patients during open-heart surgery, 3–5 ml of pericardial fluid was obtained. Concentrations of basic FGF and VEGF in the pericardial fluid were measured using an enzyme-linked immunosorbent assay (ELISA). The ELISA system for human acidic FGF was newly developed using a rabbit antibovine acidic FGF antibody. The patients were divided into three groups (group A: 13 patients undergoing emergency coronary artery bypass grafting (CABG) for unstable angina; group B: 17 patients undergoing elective CABG for stable angina; group C: 18 patients undergoing nonischemic open-heart surgery). The VEGF level in the pericardial fluid in group A was 68 ± 59 pg/ml, which was significantly higher than 33 ± 9 pg/ml in group B and 31 ± 20 pg/ml in group C (P 〈 0.05). The concentrations of basic FGF in the pericardial fluid in groups A and B were 722 ± 601 and 773 ± 763 pg/ml, respectively, significantly higher than 263 ± 349 pg/ml in group C. The pericardial acidic FGF level in group A was 4 291 ± 2 336 pg/ml, which was also significantly higher than 2 386 ± 1 048 pg/ml in group B and 2 589 ± 990 pg/ml in group C (P 〈 0.05). The acidic FGF level correlated well with the level of VEGF (r = 0.61, P 〈 0.0001). It is concluded that the level of acidic FGF in pericardial fluid is associated with severe myocardial ischemia. This result indicates that the release of acidic FGF from the myocardial tissue into pericardial fluid is closely related to severe myocardial ischemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007264
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  • 6
    Electronic Resource
    Electronic Resource
    A nuclear complex containing PPARα/RXRα is markedly downregulated in the hypertrophied rat left ventricular myocardium with normal systolic function (2000)
    Springer
    Heart and vessels 15 (2000), S. 191-196 
    Details
    ISSN: 1615-2573
    Keywords: Key words Cardiac hypertrophy ; Fatty acid metabolism ; Peroxisome proliferator-activated receptor ; Retinoid X receptor ; Acyl-coenzyme A synthetase ; Dahl salt-sensitive rat ; Dahl salt-resistant rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The expression of genes encoding fatty acid utilization enzymes is coordinately downregulated during the development of cardiac hypertrophy and failure. However, molecular mechanisms that mediate this downregulation are unknown. Peroxisome proliferator-activated receptor (PPAR) response elements (PPREs) have been identified in promoters of many genes involved in fatty acid utilization, where they function as positive regulatory elements. PPARs bind to PPREs as heterodimers with retinoid X receptors (RXRs). Primary cardiac myocytes from neonatal rats were transfected with a reporter construct driven by the C promoter of rat acyl-coenzyme A synthetase (ACS) gene. Stimulation with phenylephrine, a potent inducer of hypertrophy, markedly downregulated the activity of this promoter. By use of electrophoretic mobility-shift assays (EMSAs) using PPRE in the rat ACS promoter as a probe, we found a sequence-specific protein–DNA complex in the nuclear extract from adult rat left ventricular (LV) myocardium. Supershift experiments revealed that this complex was immunoreactive for PPARα and RXRα. We compared the activity of this complex in LV nuclear extracts from Dahl salt-sensitive rats (DSs) with hypertension and control age-matched Dahl salt-resistant rats (DRs). Even at the stage of concentric LV hypertrophy with normal systolic function, the activity of the band was markedly diminished in DSs compared with DRs. However, immunoblot analyses showed no difference in LV expression levels of PPARα or RXRα between DSs and DRs. These findings indicate that a nuclear complex of PPARα/RXRα is present in adult rat LV and is markedly downregulated in the hypertrophied LV from DS rats, which may account for the loss of transcriptional activation. The downregulation of this complex precedes LV systolic dysfunction and is mediated at the posttranslational levels.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003800070022
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  • 7
    Electronic Resource
    Electronic Resource
    Age-dependent impairment of coronary collateral development in humans (2000)
    Springer
    Heart and vessels 15 (2000), S. 176-180 
    Details
    ISSN: 1615-2573
    Keywords: Key words Age ; Angina pectoris ; Angiogenesis ; Collateral development
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to evaluate whether age influences collateral development in patients with coronary artery disease. The extent of collateral development to the area perfused by the infarct-related artery was graded, depending on the degree of opacification of the occluded infarct-related artery. We evaluated the extent of collateral development using coronary cineangiography in 102 patients with an acutely occluded infarct-related coronary artery within 12 h after the onset of the first acute myocardial infarction, and who had a history of long-standing effort angina. Well-developed collateral circulation was observed in 54 (53%) of the patients. The patients were divided into two groups based on their age. The prevalence of well-developed collateral circulation in the younger group (≤64 years, n = 48) was 69% (33 of 48), being significantly (P = 0.003) higher than 39% (21 of 54) in the older group (≥65 years, n = 54). We conclude that in the presence of stimuli for collateral development i.e., long-standing effort angina accompanied by severe coronary stenosis, the age of patients is a key determinant of collateral development.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00007269
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  • 8
    Electronic Resource
    Electronic Resource
    Significant regional heterogeneity of coronary flow reserve in paediatric hypertrophic cardiomyopathy (2000)
    Springer
    European journal of nuclear medicine 27 (2000), S. 1340-1348 
    Details
    ISSN: 1619-7089
    Keywords: Myocardial blood flow Cardiomyopathy Coronary flow reserve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Previous studies have indicated that cardiac events in young patients with hypertrophic cardiomyopathy (HCM) are related to ischaemia rather than to arrhythmia. We measured coronary flow reserve in paediatric HCM and compared the values with those in adult HCM. We studied 12 patients with HCM including six paediatric (〈20 years old; mean 13 years) and six adult patients (〉20 years old: mean 62 years), and six healthy young adults (mean 29 years) as controls. Every patient underwent magnetic resonance imaging (MRI) for anatomical assessment. Myocardial blood flow at rest and after dipyridamole infusion was measured with dynamic nitrogen-13 ammonia positron emission tomography (PET). Partial volume effect was corrected for using the anatomical data obtained with MRI. In adult patients with HCM, coronary flow reserve in the hypertrophied septal region was not significantly different from that in the non-hypertrophied lateral wall (1.38±0.29 vs 1.77±0.39, respectively). In the paediatric patients, coronary flow reserve in the hypertrophied septal region was significantly lower than in the non-hypertrophied lateral wall (0.84±0.33 vs 2.74±0.90, respectively, P〈0.01). In addition, coronary flow reserve in adult patients was lower than in control subjects both in the septal wall (1.38±0.29 vs 2.94±0.35, respectively, P〈0.0001) and in the lateral wall (1.77±0.39 vs 2.85±0.69, respectively, P〈0.05). In contrast, coronary flow reserve in paediatric patients was not significantly different from that in control subjects in the lateral wall (2.74±0.90 vs 2.85±0.69, respectively), while absolute reduction of myocardial blood flow was noted after pharmacological vasodilatation in the hypertrophied septal region. In conclusion, significant regional differences of coronary flow reserve were present in the paediatric patients with HCM. These results suggest that paediatric patients with HCM intrinsically have the potential to experience significant regional ischaemia even in the absence of coronary stenosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002590000300
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  • 9
    Electronic Resource
    Electronic Resource
    Segmental analysis of stress thallium myocardial emission tomography for localization of coronary artery disease (1984)
    Springer
    European journal of nuclear medicine 9 (1984), S. 99-105 
    Details
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The value of stress thallium 201 myocardial emission computed tomography (ECT) in the assessment of coronary artery disease (CAD) was analyzed in 75 patients admitted for coronary arteriography. The ECT provided contiguous transaxial, short-axis, and long-axis sections of the myocardium and the myocardial images were divided into nine segments. The sensitivity and specificity in the diagnosis of CAD were 95% and 93%, respectively. Using selected segments, the ECT identified 97 of 111 (83%) major vessels involved: 89% for right coronary artery (RCA), 88% for left anterior descending (LAD), and 70% for left circumflex (LCx). Among the 75 cases, 35 underwent stress conventional planar imaging within 3 months. The planar imaging provided high sensitivity (90%) and specificity (100%) for the detection of CAD patients as well, but it showed lower sensitivity (57%, P〈0.001) in identifying individual vessels involved: 55% for RCA (P〈0.01), 70% for LAD, and 36% for LCx (P〈0.05). Stress ECT detected vessel involvement more in two-vessel disease (85%) and three-vessel disease (78%) than the planar imaging (50%: P〈0.05 and 44%: P〈0.01, respectively). Thus, segmental analysis of stress ECT yielded as high sensitivity and specificity in the diagnosis of CAD as the planar imaging. This can improve sensitivity in identifying individual vessels involved in deep myocardial regions, especially in those with multivessel disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00253509
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  • 10
    Electronic Resource
    Electronic Resource
    Marked elevation of vascular endothelial growth factor and basic fibroblast growth factor in pericardial fluid of patients with angina pectoris (1998)
    Springer
    Angiogenesis 2 (1998), S. 105-108 
    Details
    ISSN: 1573-7209
    Keywords: Angiogenesis ; collateral circulation ; coronary artery bypass graft surgery ; stable angina ; unstable angina
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Although we reported that basic fibroblast growth factor (bFGF) levels in pericardial fluid of patients with unstable angina are apparently increased, it was unclear whether vascular endothelial growth factor (VEGF) is also increased in patients with myocardial ischemia. Using an enzyme-linked immunosorbent assay, we measured the concentrations of VEGF and bFGF in pericardial fluid of 51 patients with open heart surgery. Patients were divided into group A (n=10) with class III unstable angina (Braunwald's classification), group B (n=24) with class I or II unstable angina or stable angina and group C (n=17) with non-ischemic heart disease. The VEGF level in pericardial fluid in group A was 83±7 pg/ml, being significantly (p〈0.001) higher than the 27±3 pg/ml in group B and the 28±5 pg/ml in group C. The concentrations of bFGF in pericardial fluid in groups A and B were 1461±579 and 1224±161 pg/ml, respectively, significantly (p〈0.05) higher than the 292±97 pg/ml in group C. The level of VEGF in pericardial fluid was increased only in patients with severe rest angina within 2 days before emergency coronary artery bypass graft surgery (CABG), while bFGF was increased in all patients undergoing CABG for coronary artery disease. Thus VEGF and bFGF may play important roles in mediating collateral growth in humans.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1009062712441
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