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Regional interaction between myocardial sympathetic denervation, contractile dysfunction, and fibrosis in heart failure with preserved ejection fraction : 11C-hydroxyephedrine PET study

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Title: Regional interaction between myocardial sympathetic denervation, contractile dysfunction, and fibrosis in heart failure with preserved ejection fraction : 11C-hydroxyephedrine PET study
Authors: Aikawa, Tadao Browse this author →KAKEN DB
Naya, Masanao Browse this author →KAKEN DB
Obara, Masahiko Browse this author
Oyama-Manabe, Noriko Browse this author →KAKEN DB
Manabe, Osamu Browse this author →KAKEN DB
Magota, Keiichi Browse this author →KAKEN DB
Ito, Yoichi M. Browse this author →KAKEN DB
Katoh, Chietsugu Browse this author →KAKEN DB
Tamaki, Nagara Browse this author →KAKEN DB
Keywords: heart failure with preserved ejection fraction
11C-hydroxyephedrine
regional sympathetic denervation
contractile dysfunction
myocardial fibrosis
Issue Date: Oct-2017
Publisher: Springer
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 44
Issue: 11
Start Page: 1897
End Page: 1905
Publisher DOI: 10.1007/s00259-017-3760-y
PMID: 28653180
Abstract: Purpose: 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.
Rights: The final publication is available at link.springer.com
Type: article (author version)
URI: http://hdl.handle.net/2115/71560
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 相川 忠夫

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