TY - JOUR
T1 - Mechanism of impaired left ventricular wall motion in the diabetic heart without coronary artery disease
AU - Sakamoto, Ke N.Ya
AU - Yamasaki, Yoshimitsu
AU - Nanto, Shinsuke
AU - Shimonagata, Tsuyoshi
AU - Morozumi, Takakazu
AU - Ohara, Tomoki
AU - Takano, Yuzuru
AU - Nakayama, Hiroyuki
AU - Kamado, Keiji
AU - Nagata, Seiki
AU - Kusuoka, Hideo
AU - Nlshimura, Tsunehiko
AU - Hori, Masatsugu
PY - 1998
Y1 - 1998
N2 - OBJECTIVE - To elucidate whether impairment of the myocardial free fatty acid (FFA) metabolism and small vessel abnormalities in the myocardium are etiologic or contributory factors of myocardial dysfunction in patients with NIDDM without any significant coronary artery disease. RESEARCH DESIGN AND METHODS - We performed myocardial imaging with 123I-labeled β-methyl-p- iodophenyl pentadecanoic acid (BMIPP), a branched analog of FFA, and dipyridamole-infusion 201thallium scintigraphy (Dip) in nine patients who demonstrated left ventricular wall motion abnormalities without any significant coronary artery disease and in fifteen control cases. As an index of myocardial FFA metabolism, the heart-to-mediastinum count ratio (H/M) of BMIPP was calculated from the mean count in the regions of interest at the heart and the upper mediastinum. RESULTS - Nine patients with reduced wall motion documented by left ventriculography (LVG) (hypokinetic group) demonstrated significantly lower BMIPP uptake (2.1 ± 0.2, mean ± SD) than fifteen patients with normal wall motion (normokinetic group) (2.3 ± 0.2, P < 0.05). Regional ventricular wall motion observed by LVG, regional BMIPP uptake, and regional redistribution phenomenon (RD) were evaluated for five regions of the left ventricle: anterior, septal, apical, lateral, and inferoposterior regions. Wall motion was abnormal in 24 out of 120 regions. Regional BMIPP uptake was reduced in 47 regions. RD in Dip was observed in 23 regions. In regional analysis, the existence of defect in the BMIPP image showed significant correlation with wall motion abnormality (P < 0.01), but there was no significant relationship between the RD in Dip and regional wall motion abnormality (P = 0.16). Myocardial biopsy specimens obtained from the fight ventricle of 20 patients showed no pathologic changes, with the exception of two patients. CONCLUSIONS - Our findings suggest that impairment of myocardial FFA metabolism rather than small vessel abnormalities in the myocardium is responsible for modest left ventricular dysfunction in patients with diabetes.
AB - OBJECTIVE - To elucidate whether impairment of the myocardial free fatty acid (FFA) metabolism and small vessel abnormalities in the myocardium are etiologic or contributory factors of myocardial dysfunction in patients with NIDDM without any significant coronary artery disease. RESEARCH DESIGN AND METHODS - We performed myocardial imaging with 123I-labeled β-methyl-p- iodophenyl pentadecanoic acid (BMIPP), a branched analog of FFA, and dipyridamole-infusion 201thallium scintigraphy (Dip) in nine patients who demonstrated left ventricular wall motion abnormalities without any significant coronary artery disease and in fifteen control cases. As an index of myocardial FFA metabolism, the heart-to-mediastinum count ratio (H/M) of BMIPP was calculated from the mean count in the regions of interest at the heart and the upper mediastinum. RESULTS - Nine patients with reduced wall motion documented by left ventriculography (LVG) (hypokinetic group) demonstrated significantly lower BMIPP uptake (2.1 ± 0.2, mean ± SD) than fifteen patients with normal wall motion (normokinetic group) (2.3 ± 0.2, P < 0.05). Regional ventricular wall motion observed by LVG, regional BMIPP uptake, and regional redistribution phenomenon (RD) were evaluated for five regions of the left ventricle: anterior, septal, apical, lateral, and inferoposterior regions. Wall motion was abnormal in 24 out of 120 regions. Regional BMIPP uptake was reduced in 47 regions. RD in Dip was observed in 23 regions. In regional analysis, the existence of defect in the BMIPP image showed significant correlation with wall motion abnormality (P < 0.01), but there was no significant relationship between the RD in Dip and regional wall motion abnormality (P = 0.16). Myocardial biopsy specimens obtained from the fight ventricle of 20 patients showed no pathologic changes, with the exception of two patients. CONCLUSIONS - Our findings suggest that impairment of myocardial FFA metabolism rather than small vessel abnormalities in the myocardium is responsible for modest left ventricular dysfunction in patients with diabetes.
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U2 - 10.2337/diacare.21.12.2123
DO - 10.2337/diacare.21.12.2123
M3 - Article
C2 - 9839104
AN - SCOPUS:0031795589
SN - 0149-5992
VL - 21
SP - 2123
EP - 2128
JO - Diabetes care
JF - Diabetes care
IS - 12
ER -