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Acute hyperglycemia causes microvascular damage, leading to poor functional recovery and remodeling in patients with reperfused ST-segment elevation myocardial infarction

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Although acute hyperglycemia (AHG) is associated with poor outcomes in ST-segment elevation myocardial infarction (STEMI) patients, underlying mechanisms have not been fully elucidated. We investigated the influence of AHG on myocardial microcirculation in reperfused STEMI patients.

Methods and Results

Thirty-four STEMI patients were divided into 2 groups according to the presence (Group H, n = 11) or the absence (Group L, n = 23) of AHG. Myocardial blood flow (MBF) and myocardial flow reserve (MFR) in the infarct-related area were compared between 2 groups, using 13N-ammonia positron emission tomography. Wall motion abnormality scores (WMASs) and end-diastolic volume indices (EDVI) were also assessed at 1 and 6 months after the onset. Although resting MBF was similar, MFR was lower in Group H than in Group L (1.69 ± 0.37 vs 2.39 ± 0.56, P = .001). WMAS was greater in Group H than in Group L at both 1 month (7.4 ± 3.7 vs 3.7 ± 3.0, P = .011) and 6 months (7.3 ± 3.9 vs 3.1 ± 3.4, P = .015). EDVI tended to be greater in Group H than in Group L at 6 months (103.8 ± 42.9 vs 73.9 ± 16.0 mL/m2, P = .071). Multivariate analysis showed AHG to be independently associated with low MFR.

Conclusions

In STEMI patients, AHG impaired myocardial microcirculation, leading to poor functional recovery and remodeling despite successful reperfusion.

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Acknowledgments

We are grateful to Mr. Katsuya Sugimoto and all other cyclotron staff members for their technical assistance. We also wish to thank the technical and nursing staff of our cardiac catheterization laboratory and coronary care unit for their highly skilled assistance.

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Authors and Affiliations

  1. First Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Fukui, 910-1193, Japan

    Katsuhiko Sarazawa MD, Akira Nakano MD, PhD, Hiroyasu Uzui MD, PhD, Yasuhiko Mitsuke MD, PhD, Tohru Geshi MD, PhD, Takanori Ueda MD, PhD & Jong-Dae Lee MD, PhD

  2. Biomedical Imaging Research Center, University of Fukui, Fukui, Japan

    Hidehiko Okazawa MD, PhD

Authors
  1. Katsuhiko Sarazawa MD
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  2. Akira Nakano MD, PhD
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  3. Hiroyasu Uzui MD, PhD
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  4. Yasuhiko Mitsuke MD, PhD
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  5. Tohru Geshi MD, PhD
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  6. Hidehiko Okazawa MD, PhD
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  7. Takanori Ueda MD, PhD
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  8. Jong-Dae Lee MD, PhD
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Correspondence to Akira Nakano MD, PhD.

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Sarazawa, K., Nakano, A., Uzui, H. et al. Acute hyperglycemia causes microvascular damage, leading to poor functional recovery and remodeling in patients with reperfused ST-segment elevation myocardial infarction. J. Nucl. Cardiol. 19, 507–514 (2012). https://doi.org/10.1007/s12350-012-9525-x

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  • DOI: https://doi.org/10.1007/s12350-012-9525-x

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