[Activity of myocardial sympathetic-adrenal system with various volume of viable myocardium in patients with chronic cardiac failure].
OBJECTIVE
To estimate sympathetic activity in patients with ischemic heart disease (IHD) complicated by chronic cardiac failure (CCF) depending on the volume of viable myocardium measured by dobutamine stress echocardiography (DSE).


METHODS
Planar myocardial I-231-MIBG scintigraphy and dobutamine stress echocardiography were made in 16 patients (9 males and 7 females) aged 43-75 years with CCF (NYHA class II-III) and ejection fraction under 35%. The ratio maximal MIBG absorption in the left ventricular myocardium to maximal MIBG absorption in the mediastenum (H/M) and lung (H/L) were estimated.


RESULTS
By DSE the patients were divided into two groups: responders in whom contractility improved by 4 and more points (9 patients) and non-responders in whom contractility improved by less than 4 scores (7 patients). The groups did not differ by clinical and hemodynamic parameters but group 2 patients had significantly lower H/M and H/L than group 1 patients (1.38 +/- 0.02 and 1.08 +/- 0.06 against 1.61 +/- 0.09 and 1.25 +/- 0.12, respectively, p < 0.05). A direct correlation was found between MIBG absorption (H/M, H/L) and ejection fraction on minimal dobutamine doses (r = 0.77, p < 0.01; r = 0.87, p < 0.001), gain in ejection fraction (r = 0.77, p < 0.01; r = 0.45, p < 0.05), and inverse correlation between MIBG absorption (H/M, H/L) and dyssynergia index on minimal dobutamine doses (r = -0.80, p < 0.001; r = -0.87, p < 0.0001).


CONCLUSIONS
Patients with CCF demonstrate a correlation between sympathetic activity and volume of viable myocardium, inotropic reserve.
Kukes
V G
VG
Sychev
D A
DA
Andreev
D A
DA
Golukhova
E Z
EZ
Ostroumov
E N
EN
Dmitrieva
I M
IM
D000311:Adrenal Glands / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging / Q000503:physiopathology*; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009206:Myocardium / Q000473:pathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014055:Tomography, Emission-Computed
D007457:Iodine Radioisotopes