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Myocardial sympathetic innervation in patients with chronic coronary artery disease: is reduction in coronary flow reserve correlated with sympathetic denervation?

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Abstract

Purpose

Higher sensitivity of sympathetic nerves to ischaemia in comparison with myocytes has been observed and has been claimed to contribute to poor prognosis in patients with coronary artery disease (CAD). The aim of this study was to evaluate the dependency of myocardial sympathetic innervation on restrictions in coronary flow reserve (CFR).

Methods

We analysed 27 non-diabetic patients with advanced CAD. We determined quantitative myocardial blood flow using 13N-ammonia PET, myocardial viability with 18F-FDG PET and cardiac innervation with 11C-HED PET. Scarred segments were excluded from analysis. We investigated the relationship between regional HED retention, blood flow and CFR.

Results

There was no correlation between rest perfusion and HED retention within a flow range from approximately 30 to 120 ml/(100 ml·min). A slight correlation was observed between stress perfusion values and HED retention (p<0.001), and between CFR and HED retention (p<0.001).

Conclusion

In non-diabetic CAD patients, HED retention in vital myocardium does not correlate with myocardial rest perfusion over a large flow range. The observed relation between HED retention and CFR indicates that sympathetic innervation can be preserved even when there is major impairment of myocardial blood supply. Most probably the occurrence of denervation depends not only on reductions in CFR, but also on the duration and severity of resulting ischaemic episodes.

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Acknowledgement

The authors thank the technical staff of our institution for data acquisition.

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Authors and Affiliations

  1. Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine-Westphalia, Georgstrasse 11, 32545, Bad Oeynhausen, Germany

    Eva Fricke, Harald Fricke, Sytze Zijlstra, Reiner Weise, Oliver Lindner & Wolfgang Burchert

  2. Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany

    Siegfried Eckert & Dieter Horstkotte

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  1. Eva Fricke
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  2. Harald Fricke
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  3. Siegfried Eckert
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Correspondence to Eva Fricke.

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Fricke, E., Fricke, H., Eckert, S. et al. Myocardial sympathetic innervation in patients with chronic coronary artery disease: is reduction in coronary flow reserve correlated with sympathetic denervation?. Eur J Nucl Med Mol Imaging 34, 206–211 (2007). https://doi.org/10.1007/s00259-006-0236-x

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  • DOI: https://doi.org/10.1007/s00259-006-0236-x

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