title: Myocardial perfusion reserve and peripheral endothelial function in patients with idiopathic dilated cardiomyopathy.
abstract: The aim of this study was to assess the relation between peripheral endothelial function and myocardial perfusion reserve in patients with mild heart failure due to idiopathic dilated cardiomyopathy (IDC). Myocardial perfusion and brachial artery flow mediated dilation (FMD) were measured in 20 clinically stable patients with IDC (New York Heart Association classes I to III, ejection fraction 35 +/- 9%) and 13 apparently healthy subjects who were matched for age and lipid profile. Resting and hyperemic (dipyridamole; 0.56 mg/kg/min) perfusion were measured using oxygen-15-labeled water and positron emission tomography (PET). Perfusion reserve was calculated as the ratio of hyperemic to resting perfusion. FMD was assessed by measuring the change in brachial artery diameter in response to reactive hyperemia. Patients with IDC had lower hyperemic perfusion (1.73 +/- 0.83 vs 3.01 +/- 1.20 ml/min/g, p <0.001) and perfusion reserve (2.01 +/- 0.91 vs 3.08 +/- 1.35, p <0.01) compared with healthy subjects. Brachial artery FMD, however, was not different from that of the healthy subjects. Furthermore, neither hyperemic perfusion nor perfusion reserve was correlated with FMD in the patients with IDC, whereas the healthy subjects demonstrated a positive correlation between FMD and perfusion reserve (r = 0.57; p = 0.04). Thus, abnormal myocardial perfusion characterizes patients with IDC. Myocardial perfusion reserve and peripheral endothelial function do not parallel each other in patients with IDC.
authors.affiliation: Turku PET Centre, Turku, Finland.
authors.forename: Kira Q
authors.initials: KQ
authors.lastname: Stolen
authors.forename: Jukka
authors.initials: J
authors.lastname: Kemppainen
authors.forename: Kari K
authors.initials: KK
authors.lastname: Kalliokoski
authors.forename: Hannu
authors.initials: H
authors.lastname: Karanko
authors.forename: Jyri
authors.initials: J
authors.lastname: Toikka
authors.forename: Tuula
authors.initials: T
authors.lastname: Janatuinen
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.forename: K E Juhani
authors.initials: KE
authors.lastname: Airaksinen
authors.forename: Pirjo
authors.initials: P
authors.lastname: Nuutila
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
mesh_terms: D001916:Brachial Artery / Q000502:physiology; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D003326:Coronary Circulation / Q000502:physiology*; D004176:Dipyridamole; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology; D010101:Oxygen Consumption; D010104:Oxygen Radioisotopes; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D014055:Tomography, Emission-Computed; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents
chemical_list: D010104:Oxygen Radioisotopes; D014665:Vasodilator Agents; D004176:Dipyridamole; D005996:Nitroglycerin