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Impact of endothelial dysfunction on left ventricular remodeling after successful primary coronary angioplasty for acute myocardial infarction —Analysis by quantitative ECG-gated SPECT—

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Abstract

Background

We hypothesized that endothelial cell integrity in the risk area would influence left ventricular remodeling after acute myocardial infarction.

Patients and Methods

Twenty patients (61±8 y.o.) with acute myocardial infarction underwent99mTc-tetrofosmin imaging in the sub-acute phase and three months after successful primary angioplasty due to myocardial infarction. All patients were administered angiotensin-converting enzyme inhibitor after revascularization. Cardiac scintigraphies with quantitative gated SPECT were performed at the sub-acute stage and again 3 months after revascularization to evaluate left ventricular (LV) remodeling. The left ventricular ejection fraction (EF) and end-systolic and end-diastolic volume (ESV, EDV) were determined using a quantitative gated SPECT (QGS) program. Three months after myocardial infarction, all patients underwent cardiac catheterization examination with coronary endothelial function testing. Bradykinin (BK) (0.2,0.6, 2.0 μg/min) was administered via the left coronary artery in a stepwise manner. Coronary blood flow was evaluated by Doppler flow velocity measurement. Patients were divided into two groups by BK-response: a preserved endothelial function group (n= 10) and endothelial dysfunction group (n = 10).

Results

At baseline, both global function and LV systolic and diastolic volumes were similar in both groups. However, LV ejection fraction was significantly improved in the preserved-endothelial function group, compared with that in the endothelial dysfunction group (42 ± 10% to 48 ± 9%, versus 41 ± 4% to 42 ± 13%, p < 0.05). LV volumes progressively increased in the endothelial dysfunction group compared to the preserved-endothelial function group (123 ± 45 ml to 128 ± 43 ml, versus 111 ± 47 ml to 109 ± 49 ml, p < 0.05).

Conclusion

In re-perfused acute myocardial infarction, endothelial function within the risk area plays an important role with left ventricular remodeling after myocardial infarction.

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Authors and Affiliations

  1. Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta, Otsu, 520-2192, Shiga, Japan

    Shinro Matsuo, Ichiro Nakae, Tetsuya Matsumoto & Minoru Horie

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  1. Shinro Matsuo
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  2. Ichiro Nakae
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  3. Tetsuya Matsumoto
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  4. Minoru Horie
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Matsuo, S., Nakae, I., Matsumoto, T. et al. Impact of endothelial dysfunction on left ventricular remodeling after successful primary coronary angioplasty for acute myocardial infarction —Analysis by quantitative ECG-gated SPECT—. Ann Nucl Med 20, 57–62 (2006). https://doi.org/10.1007/BF02985592

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  • DOI: https://doi.org/10.1007/BF02985592

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