title: Effects of cardiac energy efficiency in diastolic heart failure: assessment with positron emission tomography with 11C-acetate.
abstract: Diastolic heart failure (DHF) has become a high social burden, and its major underlying cardiovascular disease is hypertensive heart disease. However, the pathogenesis of DHF remains to be clarified. This study aimed to assess the effects of cardiac energy efficiency in DHF patients. (11)C-Acetate positron emission tomography and echocardiography were conducted in 11 DHF Japanese patients and 10 normal volunteers. The myocardial clearance rate of radiolabeled (11)C-acetate was measured to calculate the work metabolic index (WMI), an index of cardiac efficiency. The ratio of peak mitral E wave velocity to peak early diastolic septal myocardial velocity (E/e') was calculated to assess left ventricular (LV) filling pressure. The LV mass index was greater and the mean age was higher in the DHF patients than in the normal volunteers. There was no difference in WMI between the two groups. However, WMI varied widely among the DHF patients and was inversely correlated with E/e' (r=-0.699, p=0.017). In contrast, there was no correlation in the normal volunteers. In conclusion, the inefficiency of energy utilization is not a primary cause of diastolic dysfunction or DHF, and cardiac efficiency may not affect diastolic function in normal hearts. However, the energy-wasting state may induce the elevation of LV filling pressure in DHF patients, which was considered to principally result from the progressive diastolic dysfunction.
authors: Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan. shasegawa@okn.gr.jp
authors: Shinji
authors: S
authors: Hasegawa
authors: Kazuhiro
authors: K
authors: Yamamoto
authors: Yasushi
authors: Y
authors: Sakata
authors: Yasuharu
authors: Y
authors: Takeda
authors: Katsufumi
authors: K
authors: Kajimoto
authors: Yasukazu
authors: Y
authors: Kanai
authors: Masatsugu
authors: M
authors: Hori
authors: Jun
authors: J
authors: Hatazawa
mesh_terms: D000085:Acetates / Q000378:metabolism; D000328:Adult; D000368:Aged; D002250:Carbon Radioisotopes; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D049268:Positron-Emission Tomography / Q000379:methods*; D016277:Ventricular Function, Left
chemical_list: D000085:Acetates; D002250:Carbon Radioisotopes