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Interrelation between myocardial oxidative metabolism and diastolic function in patients undergoing surgical ventricular reconstruction

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Diastolic function is impaired in patients with end-stage heart failure. Favorable structural changes by surgical ventricular reconstruction (SVR) are thought to improve diastolic function, however, previous studies reported the contradictory results. We hypothesized that cardiac oxidative metabolism and diastolic dysfunction might improve in parallel to the reduction of left ventricular chamber size after SVR.

Methods

We studied 11 patients underwent SVR associated with mitral valve repair for end-stage heart failure due to dilated cardiomyopathy. Diastolic function was assessed by echocardiography and myocardial oxidative metabolism was measured by the monoexponential clearance (k-mono) of 11C-acetate positron emission tomography at baseline and 1 month after SVR.

Results

All patients had preoperative severe diastolic dysfunction [E/A 4.11 ± 1.18, deceleration time (DT) 134 ± 26 ms]. The study patients were divided into 2 groups according to the changes in diastolic function after SVR; unchanged or worsened diastolic function in 6 patients (55 %, Non-responder) and improved diastolic function in 5 (45 %, Responder). K-mono and wall stress decreased only in responder. The changes in k-mono before and after SVR correlated with those in deceleration time (r =  –0.63; p < 0.05) and wall stress (r = 0.75; p < 0.01).

Conclusions

Improvement of diastolic dysfunction in patients with end-stage heart failure by SVR was in parallel to that in oxidative metabolism. It suggests that SVR reduced excessive metabolism during the diastolic phase, in part, via the improvement in diastolic function and the reduction in LV wall stress.

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Acknowledgments

We thank technologists Hidehiko Omote, Keiichi Magota, and Kenichi Nishijima for PET scanning, and cardiovascular surgeon Yasushige Shingu for revising the manuscript.

Funding

This work was supported by a Grant in Aid provided by Japan Society for the Promotion of Science (SC) [No. 22591313].

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

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

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

    Keiichiro Yoshinaga, Chietsugu Katoh, Osamu Manabe & Nagara Tamaki

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

    Satoru Wakasa, Suguru Kubota & Yoshiro Matsui

Authors
  1. Satoru Chiba
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  2. Masanao Naya
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  4. Keiichiro Yoshinaga
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Correspondence to Masanao Naya.

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Chiba, S., Naya, M., Iwano, H. et al. Interrelation between myocardial oxidative metabolism and diastolic function in patients undergoing surgical ventricular reconstruction. Eur J Nucl Med Mol Imaging 40, 349–355 (2013). https://doi.org/10.1007/s00259-012-2297-3

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  • DOI: https://doi.org/10.1007/s00259-012-2297-3

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