| 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)
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