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Myocardial sympathetic innervation, function, and oxidative metabolism in non-infarcted myocardium in patients with prior myocardial infarction

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Abstract

Objective

The purpose of this study was to investigate the relationship between sympathetic innervation, contractile function, and the oxidative metabolism of the non-infarcted myocardium in patients with prior myocardial infarction.

Methods

In 19 patients (14 men, 5 women, 65 ± 9 years) after prior myocardial infarction, sympathetic innervation was assessed by 11C-hydroxyephedrine (HED) positron emission tomography (PET). Oxidative metabolism was quantified using 11C-acetate PET. Left ventricular systolic function was measured by echocardiography with speckle tracking technique.

Results

The 11C-HED retention was positively correlated with left ventricular ejection fraction (LVEF) (r = 0.566, P < 0.05), and negatively with peak longitudinal strain in systole in the non-infarcted myocardium (r = −0.561, P < 0.05). Kmono, as an index of oxidative metabolism, was significantly correlated with rate pressure product (r = 0.649, P < 0.01), but not with 11C-HED retention (r = 0.188, P = 0.442). Furthermore, there was no significant correlation between Kmono and LVEF (r = 0.106, P = 0.666) or peak longitudinal strain in systole (r = −0.256, P = 0.291) in the non-infarcted myocardium. When the patients were divided into two groups based on the median value of left ventricular end-systolic volume index (LVESVI) (41 mL), there were no significant differences in age, sex, and rate pressure product between the groups. However, the large LVESVI group (>41 mL) was associated with reduced 11C-HED retention and peak longitudinal strain in systole, whereas Kmono was similar between the groups.

Conclusions

This study indicates that remodeled LV after myocardial infarction is associated with impaired sympathetic innervation and function even in the non-infarcted myocardial tissue. Furthermore, oxidative metabolism in the non-infarcted myocardium seems to be operated by normal regulatory mechanisms rather than pre-synaptic sympathetic neuronal function.

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Acknowledgments

This work was supported by Ishikawa prefectural government.

Conflict of interest

None of the authors have conflicts to disclose.

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Authors and Affiliations

  1. Department of Cardiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan

    Hirofumi Aoki, Yusuke Nomura, Wataru Fujita & Kouji Kajinami

  2. Clinical Research Department, The Medical and Pharmacological Research Center Foundation, Wo 32, Inoyama, Hakui, Ishikawa, 925-0613, Japan

    Ichiro Matsunari, Ryoko Komatsu & Yoshiharu Miyazaki

  3. Department of Nuclear Medicine, Technical University Munich, Munich, Germany

    Stephan G. Nekolla

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  1. Hirofumi Aoki
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Correspondence to Ichiro Matsunari.

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Aoki, H., Matsunari, I., Nomura, Y. et al. Myocardial sympathetic innervation, function, and oxidative metabolism in non-infarcted myocardium in patients with prior myocardial infarction. Ann Nucl Med 27, 523–531 (2013). https://doi.org/10.1007/s12149-013-0716-6

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  • DOI: https://doi.org/10.1007/s12149-013-0716-6

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