HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Knaapen, P. Articles by Visser, F. C. Search for Related Content PubMed PubMed Citation Articles by Knaapen, P. Articles by Visser, F. C.

Does Myocardial Fibrosis Hinder Contractile Function and Perfusion in Idiopathic Dilated Cardiomyopathy? PET and MR Imaging Study¹

¹ From the Departments of Cardiology (P.K., M.J.W.G., P.A.D., C.A.V., A.C.v.R., F.C.V.), Physiology (W.J.P.), Physics and Medical Technology (J.J.M.Z., J.T.M.), Nuclear Medicine and PET Research (R.B., A.A.L.), and Clinical Epidemiology and Biostatistics (J.W.R.T.), VU University Medical Center, De Boelelaan 1117, Room 6D 120, 1081 HV Amsterdam, the Netherlands. Received June 22, 2005; revision requested August 23; revision received September 9; accepted September 23; final version accepted October 31. Address correspondence to P.K. (e-mail: p.knaapen{at}vumc.nl).

Purpose: To prospectively evaluate, by using positron emission tomography (PET) and magnetic resonance (MR) imaging, the interrelationships between regional myocardial fibrosis, perfusion, and contractile function in patients with idiopathic dilated cardiomyopathy (DCM).

Materials and Methods: The study protocol was approved by the hospital ethics committee, and all subjects gave written informed consent. Sixteen patients with idiopathic DCM (mean age, 54 years ± 11 [standard deviation]; nine men) and six healthy control subjects (mean age, 28 years ± 2; five men) were examined with PET and MR tissue tagging. Oxygen 15–labeled water and carbon monoxide were used as tracers at PET to assess myocardial blood flow (MBF) and the perfusable tissue index (PTI), which is inversely related to fibrosis. MBF was determined at rest and during pharmacologically induced hyperemia. Maximum circumferential shortening (E_cc) was determined with MR tissue tagging. Student t tests were performed for comparison of data sets, and linear regression was used to investigate the association between parameters.

Results: Mean global hyperemic MBF (2.23 mL/min/mL ± 0.73), E_cc (–10.5% ± 2.9), and PTI (0.95 ± 0.10) were lower in the patients with DCM than in the control subjects (4.33 mL/min/mL ± 0.85, –17.4% ± 0.6, and 1.09 ± 0.12, respectively; P < .05 for all). In the patients with DCM, regional PTI was related to E_cc (r = –0.21, P = .009) but not to resting or hyperemic MBF. Furthermore, regional E_cc was correlated to both resting (r = –0.28, P = .004) and hyperemic MBF (r = –0.29, P < .001). In addition, the ratio of left ventricular end-diastolic volume to mass, as a reflection of wall stress, was related to global hyperemic MBF (r = –0.52, P = .047) and to global E_cc (r = 0.69, P = .003).

Conclusion: In idiopathic DCM, the extent of myocardial fibrosis is related to the impairment in contractile function, whereas fibrosis and perfusion do not seem to be interrelated. The degree of impairment of hyperemic myocardial perfusion is related to contractility and end-diastolic wall stress.

© RSNA, 2006

This article has been cited by other articles:

				M. Jerosch-Herold, D. C. Sheridan, J. D. Kushner, D. Nauman, D. Burgess, D. Dutton, R. Alharethi, D. Li, and R. E. Hershberger Cardiac magnetic resonance imaging of myocardial contrast uptake and blood flow in patients affected with idiopathic or familial dilated cardiomyopathy Am J Physiol Heart Circ Physiol, September 1, 2008; 295(3): H1234 - H1242. [Abstract] [Full Text] [PDF]