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Improvement of myocardial blood flow to ischemic regions by angiotensin- converting enzyme inhibition with quinaprilat IV

A study using [¹⁵O] water dobutamine stress positron emission tomography

Christian A. Schneider, MD, Eberhard Voth, MD^*, Detlef Moka, MD^*, Frank M. Baer, MD^a, Jacques Melin, MD, FACC, Anne Bol, PhD, Rainer Wagner, PhD, Harald Schicha, MD^*, Erland Erdmann, MD, FACC^a and Udo Sechtem, MD, FACC^a

^a Klinik III für Innere Medizin, Universität zu Köln, Cologne, Germany
^* Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln, Cologne, Germany
Positron Emission Tomography Laboratory, University of Louvain, Louvain-la-Neuve, Belgium
Max Planck Institut für Neurologische Forschung, Cologne, Germany

View larger version (13K): [in a new window]   Figure 1 Schematic diagram of the study protocol.

View larger version (17K): [in a new window]   Figure 2 Correlation between myocardial blood flow and RPP of control regions of all 18 patients during rest and stress.

View larger version (24K): [in a new window]   Figure 3 Myocardial blood flow in ischemic regions during dobutamine stress in placebo and quinaprilat patients.

View larger version (18K): [in a new window]   Figure 4 Total coronary resistance (TCR) in nonischemic regions of placebo and quinaprilat patients at rest and stress. During stress a significant decrease in TCR could be found. After quinaprilat rest, TCR significantly decreased in nonischemic regions. *p < 0.001 vs. rest.

View larger version (18K): [in a new window]   Figure 5 Total coronary resistance (TCR) in ischemic regions of placebo and quinaprilat patients at rest and stress. TCR did not change during stress in the placebo group. After quinaprilat stress, TCR significantly decreased in ischemic regions.