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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 4/2010

01-04-2010 | Original Article

Determinants of myocardial energetics and efficiency in symptomatic hypertrophic cardiomyopathy

Authors: Stefan A. J. Timmer, Tjeerd Germans, Marco J. W. Götte, Iris K. Rüssel, Pieter A. Dijkmans, Mark Lubberink, Jurrien M. ten Berg, Folkert J. ten Cate, Adriaan A. Lammertsma, Paul Knaapen, Albert C. van Rossum

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2010

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Abstract

Purpose

Next to hypertrophy, hypertrophic cardiomyopathy (HCM) is characterized by alterations in myocardial energetics. A small number of studies have shown that myocardial external efficiency (MEE), defined by external work (EW) in relation to myocardial oxidative metabolism (MVO2), is reduced. The present study was conducted to identify determinants of MEE in patients with HCM by use of dynamic positron emission tomography (PET) and cardiovascular magnetic resonance imaging (CMR).

Methods

Twenty patients with HCM (12 men, mean age: 55.2 ± 13.9 years) and 11 healthy controls (7 men, mean age: 48.1 ± 10 years) were studied with [11C]acetate PET to assess MVO2. CMR was performed to determine left ventricular (LV) volumes and mass (LVM). Univariate and multivariate analyses were employed to determine independent predictors of myocardial efficiency.

Results

Between study groups, MVO2 (controls: 0.12 ± 0.04 ml·min−1·g−1, HCM: 0.13 ± 0.05 ml·min−1·g−1, p = 0.64) and EW (controls: 9,139 ± 2,484 mmHg·ml, HCM: 9,368 ± 2,907 mmHg·ml, p = 0.83) were comparable, whereas LVM was significantly higher (controls: 99 ± 21 g, HCM: 200 ± 76 g, p < 0.001) and MEE was decreased in HCM patients (controls: 35 ± 8%, HCM: 21 ± 10%, p < 0.001). MEE was related to stroke volume (SV), LV outflow tract gradient, NH2-terminal pro-brain natriuretic peptide (NT-proBNP) and serum free fatty acid levels (all p < 0.05). Multivariate analysis revealed that SV (ß = 0.74, p < 0.001) and LVM (ß = −0.43, p = 0.013) were independently related to MEE.

Conclusion

HCM is characterized by unaltered MVO2, impaired EW generation per gram of myocardial tissue and subsequent deteriorated myocardial efficiency. Mechanical external efficiency could independently be predicted by SV and LVM.
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Metadata
Title
Determinants of myocardial energetics and efficiency in symptomatic hypertrophic cardiomyopathy
Authors
Stefan A. J. Timmer
Tjeerd Germans
Marco J. W. Götte
Iris K. Rüssel
Pieter A. Dijkmans
Mark Lubberink
Jurrien M. ten Berg
Folkert J. ten Cate
Adriaan A. Lammertsma
Paul Knaapen
Albert C. van Rossum
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-009-1350-3

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