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Prolonged dipyridamole administration reduces myocardial perfusion defects in experimental chronic Chagas cardiomyopathy

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Myocardial perfusion defects (MPD) due to coronary microvascular dysfunction is frequent in chronic Chagas cardiomyopathy (CCC) and may be involved with development of myocardial damage. We investigated whether MPD precedes left ventricular systolic dysfunction and tested the hypothesis that prolonged use of dipyridamole (DIPY) could reduce MPD in an experimental model of CCC in hamsters.

Methods and results

We investigated female hamsters 6-months after T. cruzi infection (baseline condition) and control animals, divided into T. cruzi-infected animals treated with DIPY (CH + DIPY) or placebo (CH + PLB); and uninfected animals treated with DIPY (CO + DIPY) or placebo (CO + PLB). The animals were submitted to echocardiogram and rest SPECT-Sestamibi-Tc99m myocardial perfusion scintigraphy. Next, the animals were treated with DIPY (4 mg/kg bid, intraperitoneal) or saline for 30 days, and reevaluated with the same imaging methods. At baseline, the CH + PLB and CH + DIPY groups showed larger areas of perfusion defect (13.2 ± 13.2% and 17.3 ± 13.2%, respectively) compared with CO + PLB and CO + DIPY (3.8 ± 2.2% e 3.5 ± 2.7%, respectively), P < .05. After treatment, we observed: reduction of perfusion defects only in the CH + DIPY group (17.3 ± 13.2% to 6.8 ± 7.6%, P = .001) and reduction of LVEF in CH + DIPY and CH + PLB groups (from 65.3 ± 9.0% to 53.6 ± 6.9% and from 69.3 ± 5.0% to 54.4 ± 8.6%, respectively, P < .001). Quantitative histology revealed greater extents of inflammation and interstitial fibrosis in both Chagas groups, compared with control group (P < .001), but no difference between Chagas groups (P > .05).

Conclusions

The prolonged use of DIPY in this experimental model of CCC has reduced the rest myocardial perfusion defects, supporting the notion that those areas correspond to viable hypoperfused myocardium.

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Abbreviations

CCC:

Chronic Chagas cardiomyopathy

MPD:

Myocardial perfusion defects

DIPY:

Dipyridamole

PLB:

Placebo

LV:

Left ventricle

LVEDD:

Left ventricle end diastolic dimension

LVESD:

Left ventricle end systolic dimension

LVEF:

Left ventricular ejection function

PD:

Perfusion defects

SPECT:

Single photon emission computerized tomography

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Disclosures

Denise Mayumi Tanaka, Luciano Fonseca Lemos de Oliveira, José Antônio Marin-Neto, Minna Moreira Dias Romano, Eduardo Elias Vieira de Carvalho, Antonio Carlos Leite de Barros Filho, Fernando Fonseca França Ribeiro, Jorge Mejia Cabeza, Carla Duque Lopes, Camila Godoy Fabricio, Norival Kesper, Henrique Turin Moreira, Lauro Wichert-Ana, André Schmidt, Maria de Lourdes Higuchi, Edécio Cunha-Neto, and Marcus Vinícius Simões declare that they have no conflict of interest.

Funding

This study was supported by a research grant from Fundação de Apoio à Pesquisa do Estado de São Paulo (FAPESP—Process: 2014/07722-4) and Fundação de Apoio ao Ensino Pesquisa e Assistência do Hospital das Clínicas (FAEPA).

Author information

Authors and Affiliations

  1. Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil

    Denise Mayumi Tanaka MS, Luciano Fonseca Lemos de Oliveira MS, José Antônio Marin-Neto PhD, Minna Moreira Dias Romano PhD, Antonio Carlos Leite de Barros Filho MD, Fernando Fonseca França Ribeiro MBChB, MD, Carla Duque Lopes PhD, Camila Godoy Fabricio MS, Henrique Turin Moreira PhD, Lauro Wichert-Ana PhD, André Schmidt PhD & Marcus Vinícius Simões PhD

  2. Department of Applied Physical Therapy, Institute of Health Sciences, Federal University of Triangulo Mineiro, Minas Gerais, Brazil

    Eduardo Elias Vieira de Carvalho PhD

  3. Hospital Israelita Albert Einstein, Sao Paulo, Brazil

    Jorge Mejia Cabeza PhD

  4. Instituto de Medicina Tropical, Faculty of Medicine, University os Sao Paulo, Sao Paulo, Brazil

    Norival Kesper PhD

  5. Heart Institute (InCor), Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil

    Maria de Lourdes Higuchi PhD & Edécio Cunha-Neto PhD

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  1. Denise Mayumi Tanaka MS
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  2. Luciano Fonseca Lemos de Oliveira MS
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  15. Maria de Lourdes Higuchi PhD
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  16. Edécio Cunha-Neto PhD
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  17. Marcus Vinícius Simões PhD
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Corresponding author

Correspondence to Marcus Vinícius Simões PhD.

Additional information

All editorial decisions for this article, including selection of reviewers and the final decision, were made by guest editor Alberto Cuocolo, MD.

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Tanaka, D.M., de Oliveira, L.F.L., Marin-Neto, J.A. et al. Prolonged dipyridamole administration reduces myocardial perfusion defects in experimental chronic Chagas cardiomyopathy. J. Nucl. Cardiol. 26, 1569–1579 (2019). https://doi.org/10.1007/s12350-018-1198-7

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  • DOI: https://doi.org/10.1007/s12350-018-1198-7

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