Myocardial-adrenoceptor down-regulation early after infarction is associated with long-term incidence of congestive heart failure
| Autor: | Rodney A. Foale, Stuart D. Rosen, Nicos Spyrou, Oliver Gaemperli, Riccardo Liga, Paolo G. Camici, Ornella Rimoldi, Jaspal S. Kooner |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Congestive heart failure
Adult Male medicine.medical_specialty Positron emission tomography Adrenergic beta-Antagonists Myocardial Infarction Infarction Down-Regulation Adrenoceptor C]CGP 12177 Coronary artery disease Propanolamines Interquartile range Internal medicine Coronary Circulation Receptors Adrenergic beta Receptors Medicine Humans Myocardial infarction Prospective Studies S-[ Prognosis 11 Female Heart Heart Failure Middle Aged Myocardium Positron-Emission Tomography Ventricular Remodeling business.industry Hazard ratio Coronary flow reserve medicine.disease Adrenergic Heart failure Cardiology Myocardial infarction complications beta Cardiology and Cardiovascular Medicine business |
| Popis: | Adverse left ventricular (LV) remodelling after myocardial infarction (MI) frequently leads to congestive heart failure (CHF). We have previously shown that myocardial beta-adrenoceptor density (beta-ARD) is reduced soon after acute MI and correlates with LV dilatation in the short term. The aim of the present study was to determine whether myocardial beta-ARD measured early after MI was associated with progression to CHF in the long term.We prospectively included 61 consecutive patients (mean age, 52 +/- 11 years, 10 female) in whom MI was the first manifestation of coronary artery disease. Two to 4 weeks after MI, patients underwent positron emission tomography with S-[(11)C]CGP 12177 to measure beta-ARD and (15)O-labelled water to measure myocardial blood flow and coronary flow reserve. Patients were followed-up for a median of 12.7 years (interquartile range, 6.5-13.7 years) and incidence of CHF was recorded. Eleven patients (18%) developed CHF during follow-up. They had lower beta-ARD compared with those who did not (5.35 vs. 6.49 pmol/g, P0.001). In patients with myocardial beta-ARDor =5.57 pmol/g, 10-year CHF incidence rates were higher than in patients with beta-ARD5.57 pmol/g (57% vs. 9%, P0.001). In a Cox regression model, only whole-heart beta-ARD [hazard ratio (HR) 0.29; 95% confidence interval (CI), 0.15-0.58, P0.001] and beta-ARD in remote myocardium (HR 0.32; 95% CI, 0.16-0.61, P = 0.001) were significantly associated with the incidence of CHF at follow-up.Reduced myocardial beta-ARD early after MI is associated with the incidence of CHF on long-term follow-up. |
| Databáze: | OpenAIRE |
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