title: Continuous intravenous infusion of prostaglandin E1 improves myocardial perfusion reserve in patients with ischemic heart disease assessed by positron emission tomography: a pilot study.
abstract: OBJECTIVE
  Recent investigation has demonstrated that prostaglandin E(1) (PGE(1)) therapy increased capillary density in explanted hearts. Dynamic (13)N-ammonia positron emission tomography (PET) is reliable for non-invasive measurement of myocardial blood flow and myocardial perfusion reserve (MPR). The aim of this study was to investigate the effects of PGE(1) therapy during 4 weeks on reduction of myocardial perfusion abnormalities and increase of MPR in the patients with ischemic heart disease.
  
  
  METHODS
  In this double-blind, placebo-controlled trial, we randomly assigned 11 patients who had symptomatic heart failure and documented myocardial ischemia to 4 weeks intravenous infusion of PGE(1) (2.5 ng/kg/min; 8 patients, age 60 ± 13 years) or saline (3 patients, age 57 ± 13 years). Dynamic (13)N-ammonia PET scans at rest and during adenosine stress were obtained at baseline and 12 weeks after treatment completion. Quantitative size/severity of perfusion defects and MPR change from baseline to follow-up PET were determined using a 17-segment model.
  
  
  RESULTS
  Compared with the control group, baseline MPR in the PGE(1) group was significantly lower (1.96 ± 0.78 vs. 2.71 ± 0.73; P < 0.001). MPR significantly improved 12 weeks after completion of PGE(1) infusion (1.96 ± 0.78 to 2.16 ± 0.77; P < 0.001). In contrast, MPR declined significantly in the placebo group (2.71 ± 0.73 to 2.01 ± 0.58, P < 0.001).
  
  
  CONCLUSIONS
  Four weeks of PGE(1) infusion sustained MPR improvement in patients with ischemic heart disease. This may be an attractive therapeutic approach for no-option patients with severe ischemic cardiomyopathy.
authors: Department of Internal Medicine, TaoYuan General Hospital, Taiwan.
authors: Chi-Lun
authors: CL
authors: Huang
authors: Yen-Wen
authors: YW
authors: Wu
authors: Shoei-Shen
authors: SS
authors: Wang
authors: Chuen-Den
authors: CD
authors: Tseng
authors: Fu-Tien
authors: FT
authors: Chiang
authors: Kwan-Lih
authors: KL
authors: Hsu
authors: Chii-Ming
authors: CM
authors: Lee
authors: Kai-Yuan
authors: KY
authors: Tzen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage* / Q000494:pharmacology*; D000641:Ammonia / Q000737:chemistry; D002921:Cicatrix / Q000517:prevention & control; D003326:Coronary Circulation / Q000187:drug effects*; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011446:Prospective Studies
chemical_list: D000641:Ammonia; D000527:Alprostadil