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Myocardial perfusion and oxygen consumption in reperfused noninfarcted dysfunctional myocardium after unstable angina

Direct evidence for myocardial stunning in humans

Bernhard L. Gerber, MD^*,1, William Wijns, MD, Jean-Louis J. Vanoverschelde, MD, FACC^*, Guy R. Heyndrickx, MD, Bernard De Bruyne, MD, Jozef Bartunek, MD and Jacques A. Melin, MD^*

^* Division of Cardiology and Positron Emission Tomography Laboratory, University of Louvain Medical School, Brussels, Belgium
Cardiovascular Center, Onze Lieve Vrouw-Ziekenhuis, Aalst, Belgium

View larger version (9K): [in a new window]   Figure 1 Graph illustrating the delay between first occurrence of symptoms and coronary revascularization and the time points when PET studies were performed and when functional follow-up was completed. PET = positron-emission tomography.

View larger version (12K): [in a new window]   Figure 2 Plot illustrating the time course of spontaneous recovery of contractile function of the stunned myocardium after coronary angioplasty.

View larger version (14K): [in a new window]   Figure 3 (A) Bar graph showing percentage of wall thickening in the stunned anterior and remote normally contracting region. Wall thickening was significantly reduced (p < 0.001) in the stunned myocardium. (B) Bar graph showing resting MBF in the stunned anterior and remote normally contracting region. There was no significant reduction of MBF in the anterior as compared with the remote myocardium. MBF = myocardial blood flow.

View larger version (13K): [in a new window]   Figure 4 Relationship between absolute MBF and wall thickening in the anterior region (closed circles) with respect to the remote lateral region (open circles). In the anterior region, wall thickening was found to be reduced to 9% of the remote, whereas blood flow was maintained at 87% of the remote region, thus illustrating a perfusion-contraction mismatch. MBF = myocardial blood flow.

View larger version (14K): [in a new window]   Figure 5 Bar graph showing contractile work (left) and MVO2 (right) of the dysfunctional anterior and remote lateral region. Contractile work was significantly (p < 0.001) reduced in the anterior with respect to the remote region, whereas MVO2 was found to be well-preserved. MVO2 = myocardial oxygen consumption.

View larger version (12K): [in a new window]   Figure 6 Bar graph showing contractile efficiency in the dysfunctional anterior and remote lateral regions. Anterior contractile efficiency was significantly (p < 0.001) lower than remote contractile efficiency.