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European Journal of Nuclear Medicine and Molecular Imaging

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01-03-2005 | Original Article

Effects of nicorandil on cardiac sympathetic nerve activity after reperfusion therapy in patients with first anterior acute myocardial infarction

Authors: Shu Kasama, Takuji Toyama, Hisao Kumakura, Yoshiaki Takayama, Shuichi Ichikawa, Tadashi Suzuki, Masahiko Kurabayashi

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2005

Abstract

Purpose

Ischaemic preconditioning (PC) is a cardioprotective phenomenon in which short periods of myocardial ischaemia result in resistance to decreased contractile dysfunction during a subsequent period of sustained ischaemia. Nicorandil, an ATP-sensitive potassium channel opener, can induce PC effects on sympathetic nerves during myocardial ischaemia. However, its effects on cardiac sympathetic nerve activity (CSNA) and left ventricular remodelling have not been determined. In this study, we sought to determine whether nicorandil administration improves CSNA in patients with acute myocardial infarction (AMI).

Methods

We studied 58 patients with first anterior AMI, who were randomly assigned to receive nicorandil (group A) or isosorbide dinitrate (group B) after primary coronary angioplasty. The nicorandil or isosorbide dinitrate was continuously infused for >48 h. The extent score (ES) was determined from ^99mTc-pyrophosphate scintigraphy, and the total defect score (TDS) was determined from ²⁰¹Tl scintigraphy 3–5 days after primary angioplasty. The left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were determined by left ventriculography 2 weeks later. The delayed heart/mediastinum count (H/M) ratio, delayed TDS and washout rate (WR) were determined from ¹²³I-meta-iodobenzylguanidine (MIBG) images 3 weeks later. The left ventriculography results were re-examined 6 months after treatment.

Results

Fifty patients originally enrolled in the trial completed the entire protocol. After treatment, no significant differences were observed in ES or left ventricular parameters between the two groups. However, in group A (n=25), the TDSs determined from ²⁰¹Tl and ¹²³I-MIBG were significantly lower (26±6 vs 30±5, P<0.01, and 32±8 vs 40±6, P<0.0001, respectively), the H/M ratio significantly higher (1.99±0.16 vs 1.77±0.30, P<0.005) and the WR significantly lower (36%±8% vs 44%±12%, P<0.005) than in group B (n=25). Moreover, 6 months after treatment, LVEDV and LVEF were better in group A than in group B.

Conclusion

These findings indicate that nicorandil can have beneficial effects on CSNA and left ventricular remodelling in patients with first anterior AMI.

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Title: Effects of nicorandil on cardiac sympathetic nerve activity after reperfusion therapy in patients with first anterior acute myocardial infarction
Authors: Shu Kasama
Takuji Toyama
Hisao Kumakura
Yoshiaki Takayama
Shuichi Ichikawa
Tadashi Suzuki
Masahiko Kurabayashi
Publication date: 01-03-2005
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2005
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1672-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of nicorandil on cardiac sympathetic nerve activity after reperfusion therapy in patients with first anterior acute myocardial infarction

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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