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MRC Cyclotron Unit and Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom
Cardiovascular Center, Aalst, Belgium
University of Louvain Medical School, Brussels, Belgium
Correspondence: For correspondence or reprints contact: Jacques A. Melin, MD, University of Louvain Medical School, Avenue Hippocrate 54/5430, 1200 Brussels, Belgium.
ABSTRACT
Myocardial perfusion reserve (hyperemic ÷ basal myocardial blood flow) describes vasodilator responsiveness of coronaryresistive vessels. The effect of aging and gender on myocardial perfusion reservere mains controversial. Methods: We studied 56 normal volunteers (21 women, 35 men; aged 50 ± 20 yr, range 21-86 yr) with 150-water PEF to measure myocardial blood flow during basal and hyperemic states with intravenous dipyridamole (0.56 mg/kg, n = 46) or adenosine (140 n = 10). For comparative analysis, patients were grouped according to age: <30 yr (n = 11),30–49 yr (n = 18), 50–69 yr (n = 15) and 
70 yr (n = 12). Results: Overall, basal flow was 1.00 ± 0.26 ml/min/g and hyperemic flow was 3.31 ± 1.38 ml/min/g, resulting in a myocardial perfusion reserve of 3.38 ± 1.35. There was an increase in basal flow with age (r = 0.45, p <0.025), although hyperemic flow was only lower in pafients 70 yr, causing a signfficant reduction in myocardial perfusion reserve: 3.54 ± 0.96 in <30 yr, 4.23 ± 1.35 in 30–49 yr, 3.51 ± 1.21 in 50–69 yr and 1.94 ± 0.46in 70yr (p <0.05 versus all groups <70 yr). Conclusion: My Ocardial blood flow during basal and hyperemia conditions are roughly comparable up to 60 yr of age. Above this age, there is significant increase in basal flow associated with an increase in systolic blood pressure. Above 70 yr, there is a significant reduction in hyperemic flow, and thus myocardial perfusion reserve independent of hemodynamic response to vasodilator stress.
Key Words: myocardial perfusion reserve • dipyridamole • oxygen-15-water • positron emission tomography
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