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Research ArticleCLINICAL INVESTIGATIONS

Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation

Felix T. Range, Matthias Paul, Klaus P. Schäfers, Tayfun Acil, Peter Kies, Sven Hermann, Otmar Schober, Günter Breithardt, Thomas Wichter and Michael A. Schäfers
Journal of Nuclear Medicine March 2009, 50 (3) 390-396; DOI: https://doi.org/10.2967/jnumed.108.055665
Felix T. Range
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Matthias Paul
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Klaus P. Schäfers
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Tayfun Acil
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Peter Kies
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Sven Hermann
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Otmar Schober
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Günter Breithardt
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Thomas Wichter
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Michael A. Schäfers
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  • FIGURE 1. 
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    FIGURE 1. 

    MBF in DCM/AF, DCM/SR, and controls as measured by H215O PET at baseline and under adenosine infusion (ADO). MBF at baseline has been corrected for rate–pressure product.

  • FIGURE 2. 
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    FIGURE 2. 

    Coronary flow reserve (CFR) calculated from MBF under adenosine infusion divided by baseline MBF corrected for rate–pressor product in DCM/AF, DCM/SR, and controls as determined by H215O PET.

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    FIGURE 3. 

    CVR at baseline and under adenosine administration (ADO) in DCM/AF, DCM/SR, and controls.

Tables

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    TABLE 1

    Study Population: Characteristics and Medication

    DCM/AF patientsDCM/SR patientsControl subjects
    ParameterMean ± SDnMean ± SDnMean ± SDn
    Age (y)55 ± 121243 ± 151847 ± 1322
    AF duration (mo)32 ± 399————
    NYHA class2.4 ± 0.5102.1 ± 1.117122
    Risk factors (%)
     Hypertension421222184122
     Diabetes mellitus33122218022
     Smoking421233182722
     Family history171239181822
     Hypercholesterolemia581229174522
     Obesity581222182322
    Framingham risk score13 ± 7128 ± 8159 ± 819
    Medication
     Amiodarone42*12618022
     ACE inhibitor/AT1 antagonist100*†1289†18922
     β-receptor antagonist92*†1261183222
     Calcium antagonist012618522
     Digitalis92*122218022
    • ↵* P < 0.05 vs. DCM/SR patients.

    • ↵† P < 0.05 vs. controls.

    • NYHA = New York Heart Association.

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    TABLE 2

    Echocardiographic Parameters

    ParameterDCM/AF patientsDCM/SR patientsControls
    n121822
    LA (cm)5.4 ± 1.0*†4.0 ± 1.23.9 ± 0.5
    LV EDD (cm)6.5 ± 1.06.3 ± 0.85.4 ± 0.8
    LV ESD (cm)4.5 ± 1.2*4.7 ± 0.8*3.3 ± 0.5
    PW (cm)1.2 ± 0.2*1.0 ± 0.11.1 ± 0.1
    IVS (cm)1.2 ± 0.20.9 ± 0.1*1.2 ± 0.2
    FS (%)25.2 ± 10.8*24.3 ± 5.2*39.1 ± 5.6
    LV EF (%)36.7 ± 12.4*31.7 ± 14.4*66.9 ± 5.6
    • ↵* P < 0.05 vs. controls.

    • ↵† P < 0.05 vs. DCM/SR patients.

    • LA and LV = left atrial and left ventricular diameters, respectively; EDD and ESD = end-diastolic and end-systolic diameters, respectively; PW and IVS = posterior wall and interventricular septum thicknesses, respectively; FS = fractional shortening; EF = ejection fraction.

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    TABLE 3

    Hemodynamics

    BaselineAdenosine
    ParameterDCM/AFDCM/SRControlsDCM/AFDCM/SRControls
    n121822101422
    SBP131 ± 25*110 ± 16125 ± 18128 ± 20116 ± 13130 ± 16
    DBP75 ± 1068 ± 1276 ± 872 ± 1266 ± 1373 ± 9
    MAP94 ± 13*82 ± 1292 ± 1191 ± 1383 ± 1292 ± 10
    HR66 ± 1168 ± 862 ± 867 ± 14†78 ± 1591 ± 14
    RPP8,520 ± 1,8657,476 ± 1,3077,801 ± 1,7438,552 ± 2,165†9,056 ± 2,22111,924 ± 2,336
    • ↵* P < 0.05 vs. controls.

    • ↵† P < 0.05 vs. DCM/SR patients.

    • SBP, DBP, and MAP = systolic, diastolic, and mean arterial blood pressure, respectively, in mm Hg; HR = heart rate; RPP = rate–pressure product in mm Hg × bpm.

    • View popup
    TABLE 4

    Regional Myocardial Perfusion

    MBF-RPP septalMBF-RPP anteriorMBF-RPP lateralMBF-RPP inferiorn
    Controls
     Baseline1.23 ± 0.501.11 ± 0.191.19 ± 0.281.03 ± 0.2522
     Adenosine3.68 ± 1.193.35 ± 0.853.57 ± 1.053.68 ± 1.1722
    DCM/SR
     Baseline1.07 ± 0.371.09 ± 0.331.30 ± 0.441.14 ± 0.3818
     Adenosine2.75 ± 1.722.37 ± 1.112.49 ± 1.452.65 ± 1.3914
    DCM/AF
     Baseline0.76 ± 0.330.84 ± 0.250.96 ± 0.450.73 ± 0.3312
     Adenosine1.17 ± 0.651.48 ± 0.971.58 ± 1.211.24 ± 0.9610
    • MBF-RPP = MBF corrected for RPP.

    • All values are expressed as mean ± SD.

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Journal of Nuclear Medicine: 50 (3)
Journal of Nuclear Medicine
Vol. 50, Issue 3
March 2009
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Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation
Felix T. Range, Matthias Paul, Klaus P. Schäfers, Tayfun Acil, Peter Kies, Sven Hermann, Otmar Schober, Günter Breithardt, Thomas Wichter, Michael A. Schäfers
Journal of Nuclear Medicine Mar 2009, 50 (3) 390-396; DOI: 10.2967/jnumed.108.055665

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Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation
Felix T. Range, Matthias Paul, Klaus P. Schäfers, Tayfun Acil, Peter Kies, Sven Hermann, Otmar Schober, Günter Breithardt, Thomas Wichter, Michael A. Schäfers
Journal of Nuclear Medicine Mar 2009, 50 (3) 390-396; DOI: 10.2967/jnumed.108.055665
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