[Impaired coronary flow reserve in patients with non-ischemic heart failure].
OBJECTIVE
Coronary flow reserve (CFR) is impaired not only in ischemic heart disease, but also in cardiac diseases that may or may not course with heart failure. The aim of the present study was to determine if the severity of heart failure can influence CFR impairment.


METHODS
Forty patients with non-ischemic heart disease and heart failure were studied 41 times. Four groups were established: 1. 10 patients in functional class III-IV; 2. 10 patients in functional class II not taking beta-blockers; 3. 11 patients in class II treated with carvedilol, and 4. 10 patients in class I. These patients had a history of heart failure and systolic dysfunction. Myocardial blood flow (MBF) was measured with positron emission tomography (PET) and N-13 ammonia at rest (r) and during adenosine triphosphate (ATP) infusion.


RESULTS
MBF and CFR were significantly higher in group 4 (1.95 0.58 and 2.40 0.95 ml/min/g) than in group 1 (1.02 0.52 and 1.46 0.48 ml/min/g). CFR tended to be higher in groups 2 (1.73 0.72), and 3 (1.89 0.75) vs group 1. No significant correlation was found between CFR and the following variables: age, systolic blood pressure, ventricular mass index, ventricular volume indexes, and ejection fraction.


CONCLUSIONS
Coronary microvascular function is impaired in non-ischemic heart failure, and the impairment is related to functional class, regardless of the underlying responsible heart disease.
Coma-Canella
Isabel
I
Departamento de Cardiología. Clínica Universitaria de Navarra. Facultad de Medicina. Universidad de Navarra. Pamplona, Spain. icoma@unav.es
García-Velloso
María José
MJ
Macías
Alfonso
A
Villar
Luis
L
Cosín-Sales
Juan
J
Martí-Climent
Josep M
JM
Artaiz
Miguel
M
D000368:Aged; D003326:Coronary Circulation / Q000502:physiology; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed
Disminución de la reserva de fluno coronario en pacientes co insuficiencia cardíaca no isquémica.