2024-03-29T11:48:05Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/715602022-11-17T02:08:08Zhdl_2115_20040hdl_2115_121Regional interaction between myocardial sympathetic denervation, contractile dysfunction, and fibrosis in heart failure with preserved ejection fraction : 11C-hydroxyephedrine PET studyAikawa, TadaoNaya, MasanaoObara, MasahikoOyama-Manabe, NorikoManabe, OsamuMagota, KeiichiIto, Yoichi M.Katoh, ChietsuguTamaki, Nagaraheart failure with preserved ejection fraction11C-hydroxyephedrineregional sympathetic denervationcontractile dysfunctionmyocardial fibrosis490Purpose: This investigation aimed to identify significant predictors of regional sympathetic denervation quantified by 11C-hydroxyephedrine (HED) positron emission tomography (PET) in patients with heart failure with preserved left ventricular ejection fraction (HFpEF). Methods: Thirty-four patients (63 ± 15 years, 23 male) with HFpEF (left ventricular ejection fraction ≥ 40%) and 11 age-matched volunteers without heart failure were included. Cardiac magnetic resonance imaging was performed to measure left ventricular size, function, and the extent of myocardial late gadolinium enhancement (LGE). 11C-HED PET was performed to quantify myocardial sympathetic innervation expressed as 11C-HED retention index (RI [%/min]). To identify predictors of regional 11C-HED RI in HFpEF patients, we proposed a multivariate mixed-effects model for repeated measures over segments with an unstructured covariance matrix. Results: Global 11C-HED RI was significantly lower and more heterogeneous in HFpEF patients versus volunteers (P < 0.01 for all). Regional 11C-HED RI correlated positively with systolic wall thickening (r = 0.42, P < 0.001) and negatively with the extent of LGE (r = -0.43, P < 0.001). Segments with large extent of LGE in HFpEF patients had the lowest regional 11C-HED RI among all segments (P < 0.001 for post hoc tests). Multivariate analysis demonstrated that systolic wall thickening and the extent of LGE were significant predictors of regional 11C-HED RI in HFpEF patients (both P ≤ 0.001). Conclusion: Regional sympathetic denervation was associated with contractile dysfunction and fibrotic burden in HFpEF patients, suggesting that regional sympathetic denervation may provide an integrated measure of myocardial damage in HFpEF.SpringerJournal Articleapplication/pdfhttp://hdl.handle.net/2115/71560https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/71560/1/HUSCAP_EJNM-D-17-00342_20170628.pdf1619-7070European Journal of Nuclear Medicine and Molecular Imaging4411189719052017-10enginfo:pmid/28653180info:doi/10.1007/s00259-017-3760-yThe final publication is available at link.springer.comauthor