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Myocardial oxidative metabolism is increased due to haemodynamic overload in patients with aortic valve stenosis: assessment using 11C-acetate positron emission tomography

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Abstract

Purpose

The relationship between myocardial oxidative metabolism and pressure overload in aortic valve stenosis (AS) is not fully elucidated. We identified the determinants of myocardial oxidative metabolism by measuring its changes after aortic valve replacement (AVR) in patients with AS.

Methods

Myocardial 11C-acetate clearance rate constant (Kmono), an index of oxidative metabolism, was measured non-invasively by using positron emission tomography in 16 patients with moderate to severe AS and 7 healthy controls. The severity of AS was assessed by echocardiography. Of 16 patients, 5 were reexamined at 1 month after AVR.

Results

Kmono was significantly higher in patients with AS than healthy controls by 42% (0.068 ± 0.014 vs 0.048 ± 0.007/min, p < 0.01). Kmono was significantly correlated with age (r = 0.58, p < 0.01), left ventricular (LV) mass index (r = 0.61, p < 0.01) and estimated systolic LV pressure (r = 0.81, p < 0.001) measured by echocardiography. By multivariate analysis, estimated LV systolic pressure was an independent predictor of Kmono (β = 0.93, p < 0.01). After AVR, Kmono (from 0.075 ± 0.012 to 0.061 ± 0.014/min, p = 0.043) and LV mass index (from 183 ± 49 to 124 ± 41 g/ml2, p = 0.043) were significantly decreased despite no significant changes in rate-pressure product.

Conclusion

Myocardial oxygen metabolism was increased in patients with AS, which was decreased after AVR. The increased myocardial oxidative metabolism in AS was largely attributable to the pressure overload of the LV.

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Acknowledgments

This study was supported in part by the Grants-in-Aid for Young Scientists (20790871) from the Ministry of Education, Culture, Sports, Science and Technology, Japan (MN) and in part by the Mochida Memorial Foundation for Medical and Pharmaceutical Research (MN).

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Masanao Naya, Satoru Chiba, Hiroyuki Iwano, Satoshi Yamada & Hiroyuki Tsutsui

  2. Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Keiichiro Yoshinaga

  3. Department of Health Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Chietsugu Katoh

  4. Department of Cardiovascular Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yoshiro Matsui

  5. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Osamu Manabe & Nagara Tamaki

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  1. Masanao Naya
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  2. Satoru Chiba
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  3. Hiroyuki Iwano
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  4. Satoshi Yamada
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  7. Keiichiro Yoshinaga
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  8. Yoshiro Matsui
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  9. Nagara Tamaki
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  10. Hiroyuki Tsutsui
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Correspondence to Masanao Naya.

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Naya, M., Chiba, S., Iwano, H. et al. Myocardial oxidative metabolism is increased due to haemodynamic overload in patients with aortic valve stenosis: assessment using 11C-acetate positron emission tomography. Eur J Nucl Med Mol Imaging 37, 2242–2248 (2010). https://doi.org/10.1007/s00259-010-1540-z

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  • DOI: https://doi.org/10.1007/s00259-010-1540-z

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