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Energy stores and metabolites in chronic reversibly and irreversibly dysfunctional myocardium in humans

Henrik Wiggers, MD^*, Morten Noreng, MD, Peter K. Paulsen, MD, DMSc, Morten Bøttcher, MD^* , Henrik Egeblad, MD, DMSc^*, Torsten T. Nielsen, MD, DMSc^* and Hans Erik Bøtker, MD, PhD^*

^* Department of Cardiology, Skejby Hospital, Aarhus University Hospitals, Aarhus, Denmark
Department of Anaesthesiology, Skejby Hospital, Aarhus University Hospitals, Aarhus, Denmark
Department of Thoracic Surgery, Skejby Hospital, Aarhus University Hospitals, Aarhus, Denmark
Positron Emission Tomography Center, Aarhus General Hospital, Aarhus University Hospitals, Aarhus, Denmark

View larger version (22K): [in a new window]   Figure 1 Upper panel: Partial volume corrected myocardial blood flow (ml/g/min) in biopsy regions in patients with reversible dysfunction (circles, n = 11) and irreversible dysfunction (squares, n = 12). Mean ± standard deviation is shown for each type of region. *p < 0.05 (two-way repeated measures analysis of variance, test for interaction, i.e., differences (control-dysfunctional myocardium) in the reversibly dysfunctional group versus differences in the irreversibly dysfunctional group). Ninety-five percent confidence intervals for the mean difference between dysfunctional and control regions: patients with reversible dysfunction: (–0.20; –0.05 ml/g/min). Patients with irreversible dysfunction: (–0.33; –0.14 ml/g/min). Lower panel: Relative FDG uptake (%) in biopsy regions in patients with reversible dysfunction (circles, n = 11) and irreversible dysfunction (squares, n = 12). Mean ± standard deviation is shown for each type of region. p < 0.001. Ninety-five percent confidence intervals for the mean difference between dysfunctional and control regions: patients with reversible dysfunction: (–16; 10%). Patients with irreversible dysfunction: (–57; –27%). FDG = 18F-fluoro-2-deoxyglucose.

View larger version (99K): [in a new window]   Figure 2 (A) Periodic acid Schiff stained histological section from control region with normal wall motion. (B) Periodic acid Schiff stained histological section from reversibly dysfunctional myocardium. In both regions myocytes with glycogen accumulation (arrow) and myocytes appearing normal were observed. There was no apparent difference in glycogen content between regions. (C) Biopsy from irreversibly dysfunctional myocardium stained with picrosirius red. The degree of fibrosis (red) is increased, and the amount of myocytes (yellow) is reduced. (D) Biopsy from control region with normal wall motion stained with picrosirius red.