1,342 research outputs found
Is there evidence supporting coronary revascularization in patients with left ventricular systolic dysfunction?
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Myocardial beta-adrenoceptor Density Early After Infarction Predicts Long Term Incidence of Congestive Heart Failure
No full textAims Adverse left ventricular (LV) remodeling after myocardial infarction (MI) frequently leads to congestive heart failure (CHF). We have previously shown that myocardial β-adrenoceptor density (β-ARD) is reduced soon after acute MI and correlates with LV dilatation in the short term. The aim of the present study was to determine whether myocardial β-ARD measured early after MI was associated with progression to CHF in the long term.Methods and results We prospectively included 61 consecutive patients (mean age, 52±11 years, 10 female) in whom MI was the first manifestation of coronary artery disease. Two to 4 weeks after MI, patients underwent positron emission tomography with S-[11C]CGP 12177 to measure β-ARD and 15O labelled water to measure myocardial blood flow (MBF) and coronary flow reserve (CFR). Patients were followed-up for a median of 12.7 years (interquartile range, 6.5-13.7 years) and incidence of CHF was recorded. Eleven patients (18%) developed CHF during follow-up. They had lower β-ARD compared to those who did not (5.35 vs 6.49 pmol/g, P5.57 pmol/g (57% vs. 9%, P<0.001). In a Cox regression model only whole heart β-ARD (HR 0.29; 95% CI, 0.15-0.58, P<0.001) and β-ARD in remote myocardium (HR 0.32; 95% CI, 0.16-0.61, P=0.001) were significantly associated with the incidence of CHF at follow-up. Conclusion Reduced myocardial β-ARD early after MI is associated with the incidence of CHF on long term follow-up
Systemic nitric oxide synthase inhibition improves coronary flow reserve to adenosine in patients with significant stenoses
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