Reduced sympathetic innervation underlies adjacent noninfarcted region dysfunction during left ventricular remodeling
CM Kramer,
PD Nicol,
WJ Rogers,
MM Suzuki,
A Shaffer,
TM Theobald,
and
N Reichek
Department of Medicine, Allegheny University of the Health Sciences, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA. ckramer@pgh.auhs.edu
OBJECTIVES: We examined the association of sympathetic denervation and reduced blood flow with mechanical dysfunction in adjacent noninfarcted regions late after myocardial infarction (MI). BACKGROUND: Using a well characterized ovine model of left ventricular (LV) remodeling after transmural anteroapical MI, we previously showed that histologically normal adjacent noninfarcted regions demonstrate mechanical dysfunction. METHODS: Ten sheep underwent coronary ligation. Magnetic resonance imaging was performed before and 8 weeks after infarction for measurement of LV mass, volumes, ejection fraction and regional intramyocardial circumferential shortening (%S). Iodine-123 metaiodobenzylguanidine (I-123 MIBG) and fluorescent microspheres before and after administration of adenosine were infused before death for measurement of sympathetic innervation, blood flow and blood flow reserve from matched postmortem regions. RESULTS: From baseline to 8 weeks after infarction, LV end-diastolic volume increased from (mean +/- SD) 1.5 +/- 0.3 to 2.6 +/- 0.5 ml/kg (p < 0.001), and LV mass increased from 2.0 +/- 0.3 to 2.6 +/- 0.5 g/kg (p = 0.001). Regionally, the decline in subendocardial %S was greater in adjacent (19 +/- 5% to 8 +/- 5%) than in remote noninfarcted regions (20 +/- 6% to 19 +/- 6%, p < 0.002). No difference in regional blood flow or blood flow reserve was found between adjacent and remote regions, whereas I-123 MIBG uptake was lower in adjacent than in remote myocardium (1.09 +/- 0.30 vs. 1.31 +/- 0.40 nmol/g, p < 0.003). Topographically, from apex to base at 8 weeks after infarction, %S correlated closely with I-123 MIBG uptake (r = 0.93, p = 0.003). CONCLUSIONS: In mechanically dysfunctional noninfarcted regions adjacent to chronic transmural myocardial infarction in the remodeled left ventricle, blood flow and blood flow reserve are preserved, yet sympathetic innervation is reduced. Chronic sympathetic denervation in adjacent noninfarcted regions, in association with regional mechanical dysfunction, may contribute to LV remodeling after infarction.
This article has been cited by other articles:
|
|
|
|
 
S. Kasama, T. Toyama, H. Sumino, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi
Long-Term Nicorandil Therapy Improves Cardiac Sympathetic Nerve Activity After Reperfusion Therapy in Patients with First Acute Myocardial Infarction
J. Nucl. Med.,
October 1, 2007;
48(10):
1676 - 1682.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kasama, T. Toyama, T. Hatori, H. Sumino, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi
Evaluation of cardiac sympathetic nerve activity and left ventricular remodelling in patients with dilated cardiomyopathy on the treatment containing carvedilol
Eur. Heart J.,
April 4, 2007;
(2007)
ehm048v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. J. Luisi Jr., G. Suzuki, R. deKemp, M. S. Haka, S. A. Toorongian, J. M. Canty Jr., and J. A. Fallavollita
Regional 11C-Hydroxyephedrine Retention in Hibernating Myocardium: Chronic Inhomogeneity of Sympathetic Innervation in the Absence of Infarction
J. Nucl. Med.,
August 1, 2005;
46(8):
1368 - 1374.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N G Bellenger, Z Yousef, K Rajappan, M S Marber, and D J Pennell
Infarct zone viability influences ventricular remodelling after late recanalisation of an occluded infarct related artery
Heart,
April 1, 2005;
91(4):
478 - 483.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A.K. Hasnat, E. T. van der Velde, J. K.F. Hon, and M. H. Yacoub
Reproducible model of post-infarction left ventricular dysfunction: haemodynamic characterization by conductance catheter
Eur. J. Cardiothorac. Surg.,
July 1, 2003;
24(1):
98 - 104.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. M. Muhling, Y. Wang, P. Panse, M. Jerosch-Herold, M. M. Cayton, L.S. Wann, M. M. Mirhoseini, and N. M. Wilke
Transmyocardial laser revascularization preserves regional myocardial perfusion: an MRI first pass perfusion study
Cardiovasc Res,
January 1, 2003;
57(1):
63 - 70.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. J. Luisi Jr, J. A. Fallavollita, G. Suzuki, and J. M. Canty Jr
Spatial Inhomogeneity of Sympathetic Nerve Function in Hibernating Myocardium
Circulation,
August 13, 2002;
106(7):
779 - 781.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Toyono, C Kondo, Y Nakajima, M Nakazawa, K Momma, and K Kusakabe
Effects of carvedilol on left ventricular function, mass, and scintigraphic findings in isolated left ventricular non-compaction
Heart,
July 1, 2001;
86(1):
e4 - 4.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Lee, C. M. Kramer, S. Mankad, S.-e. Yoo, and K. Sandberg
Combined angiotensin converting enzyme inhibition and angiotensin AT1 receptor blockade up-regulates myocardial AT2 receptors in remodeled myocardium post-infarction
Cardiovasc Res,
July 1, 2001;
51(1):
131 - 139.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Mankad, T. A. d'Amato, N. Reichek, W. E. McGregor, J. Lin, D. Singh, W. J. Rogers, and C. M. Kramer
Combined Angiotensin II Receptor Antagonism and Angiotensin-Converting Enzyme Inhibition Further Attenuates Postinfarction Left Ventricular Remodeling
Circulation,
June 12, 2001;
103(23):
2845 - 2850.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Saeed, G. Lund, M. F. Wendland, J. Bremerich, H.-J. Weinmann, and C. B. Higgins
Magnetic Resonance Characterization of the Peri-Infarction Zone of Reperfused Myocardial Infarction With Necrosis-Specific and Extracellular Nonspecific Contrast Media
Circulation,
February 13, 2001;
103(6):
871 - 876.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E.N Simantirakis, V.K Prassopoulos, S.I Chrysostomakis, G.E Kochiadakis, S.I Koukouraki, J.P Lekakis, N.S Karkavitsas, and P.E Vardas
Effects of asynchronous ventricular activation on myocardial adrenergic innervation in patients with permanent dual-chamber pacemakers. An I123-metaiodobenzylguanidine cardiac scintigraphic study
Eur. Heart J.,
February 2, 2001;
22(4):
323 - 332.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. J. C. Prahash, S. Gupta, and I. S. Anand
Myocyte Response to {beta}-Adrenergic Stimulation Is Preserved in the Noninfarcted Myocardium of Globally Dysfunctional Rat Hearts After Myocardial Infarction
Circulation,
October 10, 2000;
102(15):
1840 - 1846.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Igawa, T. Nozawa, N. Yoshida, N. Fujii, M. Inoue, S. Tazawa, H. Asanoi, and H. Inoue
Heterogeneous cardiac sympathetic innervation in heart failure after myocardial infarction of rats
Am J Physiol Heart Circ Physiol,
April 1, 2000;
278(4):
H1134 - H1141.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. M. Kramer, P. D. Nicol, W. J. Rogers, P. S. Seibel, C. S. Park, and N. Reichek
beta -Blockade improves adjacent regional sympathetic innervation during postinfarction remodeling
Am J Physiol Heart Circ Physiol,
October 1, 1999;
277(4):
H1429 - H1434.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
