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Continuous intravenous infusion of prostaglandin E1 improves myocardial perfusion reserve in patients with ischemic heart disease assessed by positron emission tomography: a pilot study

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Abstract

Objective

Recent investigation has demonstrated that prostaglandin E1 (PGE1) therapy increased capillary density in explanted hearts. Dynamic 13N-ammonia positron emission tomography (PET) is reliable for non-invasive measurement of myocardial blood flow and myocardial perfusion reserve (MPR). The aim of this study was to investigate the effects of PGE1 therapy during 4 weeks on reduction of myocardial perfusion abnormalities and increase of MPR in the patients with ischemic heart disease.

Methods

In this double-blind, placebo-controlled trial, we randomly assigned 11 patients who had symptomatic heart failure and documented myocardial ischemia to 4 weeks intravenous infusion of PGE1 (2.5 ng/kg/min; 8 patients, age 60 ± 13 years) or saline (3 patients, age 57 ± 13 years). Dynamic 13N-ammonia PET scans at rest and during adenosine stress were obtained at baseline and 12 weeks after treatment completion. Quantitative size/severity of perfusion defects and MPR change from baseline to follow-up PET were determined using a 17-segment model.

Results

Compared with the control group, baseline MPR in the PGE1 group was significantly lower (1.96 ± 0.78 vs. 2.71 ± 0.73; P < 0.001). MPR significantly improved 12 weeks after completion of PGE1 infusion (1.96 ± 0.78 to 2.16 ± 0.77; P < 0.001). In contrast, MPR declined significantly in the placebo group (2.71 ± 0.73 to 2.01 ± 0.58, P < 0.001).

Conclusion

Four weeks of PGE1 infusion sustained MPR improvement in patients with ischemic heart disease. This may be an attractive therapeutic approach for no-option patients with severe ischemic cardiomyopathy.

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Acknowledgments

The authors acknowledged the assistance provided by the National Taiwan University Hospital, Center for PET staff. The study was supported by Biopeutics Co. Ltd.

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Authors and Affiliations

  1. Department of Internal Medicine, TaoYuan General Hospital, TaoYuan, Taiwan

    Chi-Lun Huang

  2. Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, Taipei, 100, Taiwan

    Yen-Wen Wu, Chuen-Den Tseng, Fu-Tien Chiang & Chii-Ming Lee

  3. Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Yen-Wen Wu & Kai-Yuan Tzen

  4. Department of Radiology, Hsin-Chu General Hospital, Hsin-Chu, Taiwan

    Yen-Wen Wu

  5. Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan

    Shoei-Shen Wang

  6. Department of Laboratory Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan

    Fu-Tien Chiang

  7. Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan

    Kwan-Lih Hsu

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  1. Chi-Lun Huang
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Correspondence to Yen-Wen Wu.

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Huang, CL., Wu, YW., Wang, SS. et al. Continuous intravenous infusion of prostaglandin E1 improves myocardial perfusion reserve in patients with ischemic heart disease assessed by positron emission tomography: a pilot study. Ann Nucl Med 25, 462–468 (2011). https://doi.org/10.1007/s12149-011-0487-x

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  • DOI: https://doi.org/10.1007/s12149-011-0487-x

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