TY - JOUR
T1 - Dipyridamole vasodilator response after human orthotopic heart transplantation
T2 - Quantification by oxygen-15-labeled water and positron emission tomography
AU - Rechavia, Eldad
AU - Araujo, Luis I.
AU - de Silva, Ranil
AU - Kushwaha, Sudhir S.
AU - Lammertsma, Adriaan A.
AU - Jones, Terry
AU - Mitchell, Andrew
AU - Maseri, A'ttilio
AU - Yacoub, Magdi H.
PY - 1992/1
Y1 - 1992/1
N2 - To assess coronary vasodilator restore after orthotopic heart transplantation, regional myocardial perfusion was measured with oxygen-15-labeled water and dynamic positron emission tomography in 14 cardiac allograft recipients who were not experiencing rejection and who had no angiographic evidence of epicardial coronary sclerosis 15 to 73 months (mean ± SD 43 ± 19) after transplantation (group I). Twelve normal men with an average age of 31 years (group II) served as a control group. Regional perfusion was measured at rest and after the intravenous administration of 0.6 mg/kg body weight of dipyridamole. Rest regional myocardial blood flow was homogeneously distributed throughout the left ventricle and was significantly higher in transplant recipients (mean 1.16 ± 0.26 ml/g per min [range 0.8 to 1.73] than in normal subjects mean 0.85 ± 0.13 ml/g per min [range 0.57 to 0.99); p = 0.001) as was rest heart rate-systoll blood pressure product (rate-pressure product 11,255 ± 2,540 vs. 7,073 ± 1,306; p < 0.001). After dipyridamole, perfusion in the transplant recipients was homogeneous and slightly lower (2.73 ±1.03 vs. 3.40 ± 1.09 ml/g per min; p = NS), whereas rate-pressure product was slightly higher (12,179 ± 2,266 vs. 10,885 ± 1,895: p = NS) than the value in normal subjects. Dipyridamole vasodilator response (dipyridamole/rest myocardial blood flow) ranged from 1.23 to 4.92 (mean 2.50 ± 1.13) in group I and from 2.65 to 5.45 (3.97 ± 0.89) in group II (p = 0.001). Rate-pressure product change (dipyridammole/rest rate-pressure product) was markedly attenuated in transplant recipients compred with the value in normal subjects (1.09 ± 0.09 vs. 1.56 ± 0.27 ml/g/per min; p < 0,001). Normalization for the difference in rest rate-pressure product for each individual subject showed that the adjusted rest show values (group 11.19 ± 0.27, group II 1.39 ± 0.31 ml/g per min; p = NS) and the dipyridamole-vasodilator response data (group I 2.45 ± 0.64, group II 2.47 ± 1.23, p = NS) in the two groups were not significantly different. Thus, in transplant recipients who are not experiencing rejection, the respons iveness of the coronary vasculature to dipyridamole-mediated vasodilation is uniformly preserved among all regions of the left ventricular myocardium.
AB - To assess coronary vasodilator restore after orthotopic heart transplantation, regional myocardial perfusion was measured with oxygen-15-labeled water and dynamic positron emission tomography in 14 cardiac allograft recipients who were not experiencing rejection and who had no angiographic evidence of epicardial coronary sclerosis 15 to 73 months (mean ± SD 43 ± 19) after transplantation (group I). Twelve normal men with an average age of 31 years (group II) served as a control group. Regional perfusion was measured at rest and after the intravenous administration of 0.6 mg/kg body weight of dipyridamole. Rest regional myocardial blood flow was homogeneously distributed throughout the left ventricle and was significantly higher in transplant recipients (mean 1.16 ± 0.26 ml/g per min [range 0.8 to 1.73] than in normal subjects mean 0.85 ± 0.13 ml/g per min [range 0.57 to 0.99); p = 0.001) as was rest heart rate-systoll blood pressure product (rate-pressure product 11,255 ± 2,540 vs. 7,073 ± 1,306; p < 0.001). After dipyridamole, perfusion in the transplant recipients was homogeneous and slightly lower (2.73 ±1.03 vs. 3.40 ± 1.09 ml/g per min; p = NS), whereas rate-pressure product was slightly higher (12,179 ± 2,266 vs. 10,885 ± 1,895: p = NS) than the value in normal subjects. Dipyridamole vasodilator response (dipyridamole/rest myocardial blood flow) ranged from 1.23 to 4.92 (mean 2.50 ± 1.13) in group I and from 2.65 to 5.45 (3.97 ± 0.89) in group II (p = 0.001). Rate-pressure product change (dipyridammole/rest rate-pressure product) was markedly attenuated in transplant recipients compred with the value in normal subjects (1.09 ± 0.09 vs. 1.56 ± 0.27 ml/g/per min; p < 0,001). Normalization for the difference in rest rate-pressure product for each individual subject showed that the adjusted rest show values (group 11.19 ± 0.27, group II 1.39 ± 0.31 ml/g per min; p = NS) and the dipyridamole-vasodilator response data (group I 2.45 ± 0.64, group II 2.47 ± 1.23, p = NS) in the two groups were not significantly different. Thus, in transplant recipients who are not experiencing rejection, the respons iveness of the coronary vasculature to dipyridamole-mediated vasodilation is uniformly preserved among all regions of the left ventricular myocardium.
UR - http://www.scopus.com/inward/record.url?scp=0026530601&partnerID=8YFLogxK
U2 - 10.1016/0735-1097(92)90058-U
DO - 10.1016/0735-1097(92)90058-U
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 1729318
AN - SCOPUS:0026530601
SN - 0735-1097
VL - 19
SP - 100
EP - 106
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 1
ER -