No Evidence of Myocardial Oxygen Deprivation in Nonischemic Heart Failure

Circulation. Heart Failure
Sairia DassS Neubauer

Abstract

Whether the myocardium in nonischemic heart failure experiences oxygen limitation remains a long-standing controversy. We addressed this question in patients with dilated cardiomyopathy (DCM) using a dual approach. First, we tested the changes in myocardial oxygenation between rest and stress states, using oxygenation-sensitive cardiovascular magnetic resonance. Second, we sought to assess the functional consequences of oxygen limitation at rest by measuring myocardial energetics before and after short-term oxygen supplementation. Twenty-six subjects (14 DCM and 12 normal) underwent cardiac magnetic resonance imaging at 3 Tesla to assess cardiac volumes, function, oxygenation, and first-pass perfusion (0.03 mmol/kg Gd-DTPA bolus) at stress and rest (4-6 minutes IV adenosine, 140 μg/kg per minute). Signal intensity change (SIΔ) and myocardial perfusion reserve index (MPRI) were measured from oxygenation and perfusion images, respectively. Furthermore, the effect of oxygen supplementation on resting myocardial energy metabolism was tested using (31)P MR spectroscopy, measuring PCr/ATP ratios in both groups at baseline and after 4 hours of oxygen via facemask in the DCM group. During stress, there were equivalent rises in rate pre...Continue Reading

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Nov 19, 2015·Circulation. Heart Failure·Jie Zheng, Robert J Gropler
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Aug 12, 2021·Current Heart Failure Reports·Elizabeth Hillier, Matthias G Friedrich

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Software Mentioned

MedCalc
Java Magnetic Resonance User Interface
QMass
Argus
SPSS Statistics

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