Myocardial perfusion reserve and oxidative metabolism contribute to exercise capacity in patients with dilated cardiomyopathy

Exercise intolerance is a hallmark symptom in patients with heart failure; however, myocardial factors contributing to the limited exercise capacity are not fully characterized. Twenty patients with stable heart failure resulting from idiopathic dilated cardiomyopathy (DCM) and 13 controls were stud...

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Bibliographic Details
Published in:Journal of cardiac failure 2004-04, Vol.10 (2), p.132-140
Main Authors: Stolen, Kira Q., Kemppainen, Jukka, Kalliokoski, Kari K., Hällsten, Kirsti, Luotolahti, Matti, Karanko, Hannu, Lehikoinen, Pertti, Viljanen, Tapio, Salo, Tiina, Juhani Airaksinen, K.E., Nuutila, Pirjo, Knuuti, Juhani
Format: Article
Language:English
Subjects:
Cardiomyopathy, Dilated - diagnostic imaging
Cardiomyopathy, Dilated - metabolism
Cardiomyopathy, Dilated - physiopathology
Case-Control Studies
Exercise Test
Exercise Tolerance - physiology
Female
Fluorodeoxyglucose F18
functional capacity
Glucose - metabolism
Heart - diagnostic imaging
Heart failure
Humans
Male
Middle Aged
Myocardium - metabolism
Oxygen Consumption
Oxygen Radioisotopes
positron emission tomography
Radiopharmaceuticals
Tomography, Emission-Computed
Ventricular Function, Left - physiology
Water
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Summary:Exercise intolerance is a hallmark symptom in patients with heart failure; however, myocardial factors contributing to the limited exercise capacity are not fully characterized. Twenty patients with stable heart failure resulting from idiopathic dilated cardiomyopathy (DCM) and 13 controls were studied. Myocardial perfusion, biventricular oxidative metabolism, and insulin-stimulated glucose uptake were measured using positron emission tomography and [15O]H2O, [11C]acetate, and [18F]FDG. Hyperemic perfusion and perfusion reserve were significantly lower in the DCM patients compared with the healthy subjects. There was no difference in left ventricular oxidative metabolism between the 2 groups; however, the patients had a 19% higher right ventricular oxidative metabolism (P=.005). Consequently, the ratio of right to left ventricular oxidative metabolism was also higher (31%) in the patients. There was a strong inverse association between decreased exercise capacity and the ratio of right to left ventricular oxidative metabolism (r=–.68, P
ISSN:1071-9164
1532-8414
DOI:10.1016/j.cardfail.2003.08.009