Patients with mild dilated cardiomyopathy had significantly lower myocardial blood flow after dipyridamole infusion compared to healthy controls (1.91 vs 3.78 mL/min/g, P<0.01).
Observational (n=35)
Is myocardial blood flow impaired at rest and in response to vasodilating stimuli in patients with mild dilated cardiomyopathy without overt heart failure compared to healthy subjects?
Patients with mild dilated cardiomyopathy without overt heart failure exhibit significant impairment in myocardial perfusion both at rest and in response to vasodilating stimuli, independent of hemodynamic factors.
Absolute Event Rate: 1.91% vs 3.78%
p-value: p=<.01
BACKGROUND: Myocardial blood flow (MBF) impairment has been documented in advanced dilated cardiomyopathy (DCM) in which hemodynamic factors, secondary to severe ventricular dysfunction, may limit myocardial perfusion. To assess whether MBF impairment in DCM may also be present independent of hemodynamic factors, the present study was designed to quantify myocardial perfusion in patients with mild disease without overt heart failure. METHODS AND RESULTS: Absolute regional MBF (milliliters per minute per gram) was measured by positron emission tomography and 13N-ammonia in resting conditions, during pacing-induced tachycardia, and after dipyridamole infusion (0.56 mg/kg over 4 minutes) in 22 DCM patients and in 13 healthy subjects. Patients were in New York Heart Association functional class I-II and showed depressed left ventricular (LV) ejection fraction by radionuclide angiography (35 +/- 8%; range, 21% to 48%), normal coronary angiography, and normal or moderately increased LV end-diastolic pressure (9.2 +/- 5.5 mm Hg; range, 2 to 20 mm Hg). There were no differences in arterial blood pressure, heart rate, and rate-pressure product between patients and control subjects in the three study conditions. Compared with control subjects, DCM patients had lower mean MBF at rest (0.80 +/- 0.25 versus 1.08 +/- 0.20 mL.min-1.g-1, P 12 mm Hg; in 4, myocardial perfusion was severely depressed both at baseline and in response to stress. CONCLUSIONS: In patients with DCM without overt heart failure, myocardial perfusion is impaired both at rest and in response to vasodilating stimuli. The abnormalities in vasodilating capability can be present despite normal hemodynamics; progression of the disease is associated with more depressed myocardial perfusion.
Neglia et al. (1995) conducted an observational in Dilated cardiomyopathy without overt heart failure (n=35). Dilated cardiomyopathy vs. Healthy subjects was evaluated on Mean myocardial blood flow after dipyridamole infusion (mL/min/g) (p=<.01). Patients with mild dilated cardiomyopathy had significantly lower myocardial blood flow after dipyridamole infusion compared to healthy controls (1.91 vs 3.78 mL/min/g, P<0.01).