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Myocardial perfusion and sympathetic innervation in patients with hypertrophic cardiomyopathy

Sheng-Ting Li, MD, PhD^*, Cees J. Tack, MD, Lameh Fananapazir, MD and David S. Goldstein, MD, PhD^*

^* Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892 USA
Department of Internal Medicine, University Hospital, Nijmegen, The Netherlands
Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892 USA

View larger version (26K): [in a new window]   Figure 1 The structure (A) and fate of 6-[18F]-fluorodopamine (B).

View larger version (60K): [in a new window]   Figure 2 Thoracic positron emission tomographic scans depicting (left) myocardial 13N-ammonia–derived radioactivity, (middle) 6-[18F]-fluorodopamine–derived radioactivity, and (right) the ratio of 18F:13N in (top) a normal volunteer and (bottom) a patient with hypertrophic cardiomyopathy, after IV injection of 5 mCi 13N-ammonia and then 1 mCi 6-[18F]-fluorodopamine. Sep = septum; Lat = lateral wall; Ap = apex; LV = left ventricle.

View larger version (78K): [in a new window]   Figure 3 13NH3-Derived radioactivity in patients with hypertrophic cardiomyopathy and normal volunteers. HCM = average myocardial radioactivity of patients with hypertrophic cardiomyopathy (n = 8); HY = radioactivity in hypertrophied regions of patients with HCM (n = 8); NH = radioactivity in nonhypertrophied regions of patients with HCM (n = 5); NL = average radioactivity in left ventricular myocardium of normal volunteers (n = 15); NF = radioactivity in left ventricular free wall of normal volunteers (n = 15); NS = radioactivity in septum of normal volunteers (n = 15).

View larger version (22K): [in a new window]   Figure 4 Mean values (±SEM) for the ratio of 18F:13N in septum or average of left ventricular myocardium of normal volunteers (n = 15) and in hypertrophied (n = 8) and nonhypertrophied regions (n = 5) of patients with hypertrophic cardiomyopathy, after injection of 13N-ammonia and then 6-[18F]-fluorodopamine.

View larger version (16K): [in a new window]   Figure 5 Relationship between peak 18F-FDA–derived radioactivity and 13NH3-derived radioactivity in hypertrophied and nonhypertrophied regions of 7 patients with HCM (another 1 outlier deleted) and in left ventricular myocardium of 15 normal volunteers.