Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium

Gianmario Sambuceti, Assuero Giorgetti, Luca Corsiglia, Cecilia Marini, Jan Schneider-Eicke, Claudio Brunelli, Paolo Marzullo, Antonio L'Abbate, Salvatore Capponnetto, Oberdan Parodi

Research output: Contribution to journalArticle

Abstract

The aims of this study were to assess the value of dobutamine echocardiography in identifying myocardial hibernation versus stunning and to elucidate the underlying pathophysiological mechanism of the contractile impairment. Methods: Twenty-one patients with isolated stenosis of the left anterior descending artery were evaluated 1 mo after thrombolysed acute anterior infarction. Regional function and blood flow were measured using echocardiography and PEt at rest and during dobutamine administration (10 μg/kg/min). Results: Defined by [18F]fluorodeoxyglucose uptake, 36 of 102 dyssynergic segments were necrotic, and 66 were viable. The latter segments were subdivided according to their [13N]ammonia flow distribution: 30 hibernating regions with perfusion defects (flow of -1 · g-1; not significant), and both resting values were lower than those seen in stunning (0.79 ± 0.24; p <0.05). Flow response to dobutamine was markedly reduced in necrosis (dobutamine/resting flow = 1.16 ± 0.27), whereas it was maintained in hibernation (1.65 ± 0.54) and stunning (1.42 ± 0.57). Dobutamine improved function in a higher number of stunned (55%) than hibernating (16%) or necrotic (11%) segments. Conclusion: Dobutamine improves function mainly in stunned myocardium and does not reliably identify hibernation. The lack of functional response in hibernation is not related to an exhausted vasodilating capacity.

Original languageEnglish
Pages (from-to)396-402
Number of pages7
JournalJournal of Nuclear Medicine
Volume39
Issue number3
Publication statusPublished - Mar 1998

Fingerprint

Dobutamine
Myocardium
Perfusion
Hibernation
Myocardial Stunning
Echocardiography
Fluorodeoxyglucose F18
Regional Blood Flow
Ammonia
Infarction
Pathologic Constriction
Necrosis
Arteries

Keywords

  • Echocardiography
  • Myocardial blood flow
  • Myocardial infarction
  • PET

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Sambuceti, G., Giorgetti, A., Corsiglia, L., Marini, C., Schneider-Eicke, J., Brunelli, C., ... Parodi, O. (1998). Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium. Journal of Nuclear Medicine, 39(3), 396-402.

Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium. / Sambuceti, Gianmario; Giorgetti, Assuero; Corsiglia, Luca; Marini, Cecilia; Schneider-Eicke, Jan; Brunelli, Claudio; Marzullo, Paolo; L'Abbate, Antonio; Capponnetto, Salvatore; Parodi, Oberdan.

In: Journal of Nuclear Medicine, Vol. 39, No. 3, 03.1998, p. 396-402.

Research output: Contribution to journalArticle

Sambuceti, G, Giorgetti, A, Corsiglia, L, Marini, C, Schneider-Eicke, J, Brunelli, C, Marzullo, P, L'Abbate, A, Capponnetto, S & Parodi, O 1998, 'Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium', Journal of Nuclear Medicine, vol. 39, no. 3, pp. 396-402.
Sambuceti G, Giorgetti A, Corsiglia L, Marini C, Schneider-Eicke J, Brunelli C et al. Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium. Journal of Nuclear Medicine. 1998 Mar;39(3):396-402.
Sambuceti, Gianmario ; Giorgetti, Assuero ; Corsiglia, Luca ; Marini, Cecilia ; Schneider-Eicke, Jan ; Brunelli, Claudio ; Marzullo, Paolo ; L'Abbate, Antonio ; Capponnetto, Salvatore ; Parodi, Oberdan. / Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium. In: Journal of Nuclear Medicine. 1998 ; Vol. 39, No. 3. pp. 396-402.
@article{cd335b8b7ff14731967acd1ddfcee8bc,
title = "Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium",
abstract = "The aims of this study were to assess the value of dobutamine echocardiography in identifying myocardial hibernation versus stunning and to elucidate the underlying pathophysiological mechanism of the contractile impairment. Methods: Twenty-one patients with isolated stenosis of the left anterior descending artery were evaluated 1 mo after thrombolysed acute anterior infarction. Regional function and blood flow were measured using echocardiography and PEt at rest and during dobutamine administration (10 μg/kg/min). Results: Defined by [18F]fluorodeoxyglucose uptake, 36 of 102 dyssynergic segments were necrotic, and 66 were viable. The latter segments were subdivided according to their [13N]ammonia flow distribution: 30 hibernating regions with perfusion defects (flow of -1 · g-1; not significant), and both resting values were lower than those seen in stunning (0.79 ± 0.24; p <0.05). Flow response to dobutamine was markedly reduced in necrosis (dobutamine/resting flow = 1.16 ± 0.27), whereas it was maintained in hibernation (1.65 ± 0.54) and stunning (1.42 ± 0.57). Dobutamine improved function in a higher number of stunned (55{\%}) than hibernating (16{\%}) or necrotic (11{\%}) segments. Conclusion: Dobutamine improves function mainly in stunned myocardium and does not reliably identify hibernation. The lack of functional response in hibernation is not related to an exhausted vasodilating capacity.",
keywords = "Echocardiography, Myocardial blood flow, Myocardial infarction, PET",
author = "Gianmario Sambuceti and Assuero Giorgetti and Luca Corsiglia and Cecilia Marini and Jan Schneider-Eicke and Claudio Brunelli and Paolo Marzullo and Antonio L'Abbate and Salvatore Capponnetto and Oberdan Parodi",
year = "1998",
month = "3",
language = "English",
volume = "39",
pages = "396--402",
journal = "Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "3",

}

TY - JOUR

T1 - Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium

AU - Sambuceti, Gianmario

AU - Giorgetti, Assuero

AU - Corsiglia, Luca

AU - Marini, Cecilia

AU - Schneider-Eicke, Jan

AU - Brunelli, Claudio

AU - Marzullo, Paolo

AU - L'Abbate, Antonio

AU - Capponnetto, Salvatore

AU - Parodi, Oberdan

PY - 1998/3

Y1 - 1998/3

N2 - The aims of this study were to assess the value of dobutamine echocardiography in identifying myocardial hibernation versus stunning and to elucidate the underlying pathophysiological mechanism of the contractile impairment. Methods: Twenty-one patients with isolated stenosis of the left anterior descending artery were evaluated 1 mo after thrombolysed acute anterior infarction. Regional function and blood flow were measured using echocardiography and PEt at rest and during dobutamine administration (10 μg/kg/min). Results: Defined by [18F]fluorodeoxyglucose uptake, 36 of 102 dyssynergic segments were necrotic, and 66 were viable. The latter segments were subdivided according to their [13N]ammonia flow distribution: 30 hibernating regions with perfusion defects (flow of -1 · g-1; not significant), and both resting values were lower than those seen in stunning (0.79 ± 0.24; p <0.05). Flow response to dobutamine was markedly reduced in necrosis (dobutamine/resting flow = 1.16 ± 0.27), whereas it was maintained in hibernation (1.65 ± 0.54) and stunning (1.42 ± 0.57). Dobutamine improved function in a higher number of stunned (55%) than hibernating (16%) or necrotic (11%) segments. Conclusion: Dobutamine improves function mainly in stunned myocardium and does not reliably identify hibernation. The lack of functional response in hibernation is not related to an exhausted vasodilating capacity.

AB - The aims of this study were to assess the value of dobutamine echocardiography in identifying myocardial hibernation versus stunning and to elucidate the underlying pathophysiological mechanism of the contractile impairment. Methods: Twenty-one patients with isolated stenosis of the left anterior descending artery were evaluated 1 mo after thrombolysed acute anterior infarction. Regional function and blood flow were measured using echocardiography and PEt at rest and during dobutamine administration (10 μg/kg/min). Results: Defined by [18F]fluorodeoxyglucose uptake, 36 of 102 dyssynergic segments were necrotic, and 66 were viable. The latter segments were subdivided according to their [13N]ammonia flow distribution: 30 hibernating regions with perfusion defects (flow of -1 · g-1; not significant), and both resting values were lower than those seen in stunning (0.79 ± 0.24; p <0.05). Flow response to dobutamine was markedly reduced in necrosis (dobutamine/resting flow = 1.16 ± 0.27), whereas it was maintained in hibernation (1.65 ± 0.54) and stunning (1.42 ± 0.57). Dobutamine improved function in a higher number of stunned (55%) than hibernating (16%) or necrotic (11%) segments. Conclusion: Dobutamine improves function mainly in stunned myocardium and does not reliably identify hibernation. The lack of functional response in hibernation is not related to an exhausted vasodilating capacity.

KW - Echocardiography

KW - Myocardial blood flow

KW - Myocardial infarction

KW - PET

UR - http://www.scopus.com/inward/record.url?scp=0031881673&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031881673&partnerID=8YFLogxK

M3 - Article

C2 - 9529281

AN - SCOPUS:0031881673

VL - 39

SP - 396

EP - 402

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

SN - 0161-5505

IS - 3

ER -