Prolonged dipyridamole administration reduces myocardial perfusion defects in experimental chronic Chagas cardiomyopathy.

Autor: Tanaka DM; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., de Oliveira LFL; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Marin-Neto JA; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Romano MMD; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., de Carvalho EEV; Department of Applied Physical Therapy, Institute of Health Sciences, Federal University of Triangulo Mineiro, Minas Gerais, Brazil., de Barros Filho ACL; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Ribeiro FFF; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Cabeza JM; Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Lopes CD; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Fabricio CG; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Kesper N; Instituto de Medicina Tropical, Faculty of Medicine, University os Sao Paulo, Sao Paulo, Brazil., Moreira HT; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Wichert-Ana L; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Schmidt A; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil., Higuchi ML; Heart Institute (InCor), Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Cunha-Neto E; Heart Institute (InCor), Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Simões MV; Medical School of Ribeirao Preto, University of São Paulo, Sao Paulo, Brazil. msimoes@fmrp.usp.br.
Jazyk: angličtina
Zdroj: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2019 Oct; Vol. 26 (5), pp. 1569-1579. Date of Electronic Publication: 2018 Feb 01.
DOI: 10.1007/s12350-018-1198-7
Abstrakt: Background: Myocardial perfusion defects (MPD) due to coronary microvascular dysfunction is frequent in chronic Chagas cardiomyopathy (CCC) and may be involved with development of myocardial damage. We investigated whether MPD precedes left ventricular systolic dysfunction and tested the hypothesis that prolonged use of dipyridamole (DIPY) could reduce MPD in an experimental model of CCC in hamsters.
Methods and Results: We investigated female hamsters 6-months after T. cruzi infection (baseline condition) and control animals, divided into T. cruzi-infected animals treated with DIPY (CH + DIPY) or placebo (CH + PLB); and uninfected animals treated with DIPY (CO + DIPY) or placebo (CO + PLB). The animals were submitted to echocardiogram and rest SPECT-Sestamibi-Tc99m myocardial perfusion scintigraphy. Next, the animals were treated with DIPY (4 mg/kg bid, intraperitoneal) or saline for 30 days, and reevaluated with the same imaging methods. At baseline, the CH + PLB and CH + DIPY groups showed larger areas of perfusion defect (13.2 ± 13.2% and 17.3 ± 13.2%, respectively) compared with CO + PLB and CO + DIPY (3.8 ± 2.2% e 3.5 ± 2.7%, respectively), P < .05. After treatment, we observed: reduction of perfusion defects only in the CH + DIPY group (17.3 ± 13.2% to 6.8 ± 7.6%, P = .001) and reduction of LVEF in CH + DIPY and CH + PLB groups (from 65.3 ± 9.0% to 53.6 ± 6.9% and from 69.3 ± 5.0% to 54.4 ± 8.6%, respectively, P < .001). Quantitative histology revealed greater extents of inflammation and interstitial fibrosis in both Chagas groups, compared with control group (P < .001), but no difference between Chagas groups (P > .05).
Conclusions: The prolonged use of DIPY in this experimental model of CCC has reduced the rest myocardial perfusion defects, supporting the notion that those areas correspond to viable hypoperfused myocardium.
Databáze: MEDLINE
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