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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 3/2013

01-02-2013 | Original Article

Interrelation between myocardial oxidative metabolism and diastolic function in patients undergoing surgical ventricular reconstruction

Authors: Satoru Chiba, Masanao Naya, Hiroyuki Iwano, Keiichiro Yoshinaga, Chietsugu Katoh, Osamu Manabe, Satoshi Yamada, Satoru Wakasa, Suguru Kubota, Yoshiro Matsui, Nagara Tamaki, Hiroyuki Tsutsui

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2013

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Abstract

Purpose

Diastolic function is impaired in patients with end-stage heart failure. Favorable structural changes by surgical ventricular reconstruction (SVR) are thought to improve diastolic function, however, previous studies reported the contradictory results. We hypothesized that cardiac oxidative metabolism and diastolic dysfunction might improve in parallel to the reduction of left ventricular chamber size after SVR.

Methods

We studied 11 patients underwent SVR associated with mitral valve repair for end-stage heart failure due to dilated cardiomyopathy. Diastolic function was assessed by echocardiography and myocardial oxidative metabolism was measured by the monoexponential clearance (k-mono) of 11C-acetate positron emission tomography at baseline and 1 month after SVR.

Results

All patients had preoperative severe diastolic dysfunction [E/A 4.11 ± 1.18, deceleration time (DT) 134 ± 26 ms]. The study patients were divided into 2 groups according to the changes in diastolic function after SVR; unchanged or worsened diastolic function in 6 patients (55 %, Non-responder) and improved diastolic function in 5 (45 %, Responder). K-mono and wall stress decreased only in responder. The changes in k-mono before and after SVR correlated with those in deceleration time (r =  –0.63; p < 0.05) and wall stress (r = 0.75; p < 0.01).

Conclusions

Improvement of diastolic dysfunction in patients with end-stage heart failure by SVR was in parallel to that in oxidative metabolism. It suggests that SVR reduced excessive metabolism during the diastolic phase, in part, via the improvement in diastolic function and the reduction in LV wall stress.
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Metadata
Title
Interrelation between myocardial oxidative metabolism and diastolic function in patients undergoing surgical ventricular reconstruction
Authors
Satoru Chiba
Masanao Naya
Hiroyuki Iwano
Keiichiro Yoshinaga
Chietsugu Katoh
Osamu Manabe
Satoshi Yamada
Satoru Wakasa
Suguru Kubota
Yoshiro Matsui
Nagara Tamaki
Hiroyuki Tsutsui
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-012-2297-3

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