Microvascular dysfunction in nonfailing arrhythmogenic right ventricular cardiomyopathy.

Paul M, Rahbar K, Gerss J, Kies P, Schober O, Schäfers K, Breithardt G, Schulze-Bahr E, Wichter T, Schäfers M

Research article (journal)

Abstract

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a nonischaemic cardiomyopathy and leading cause of sudden death in the young. It has been shown that microvascular dysfunction reflected by an impaired myocardial blood flow (MBF) response to stress is present in patients with other forms of nonischaemic cardiomyopathy, e.g. dilated cardiomyopathy, and that the reduced MBF may be related to a poor prognosis. Therefore, we quantified MBF, coronary flow reserve and coronary vascular resistance in patients with nonfailing ARVC using H (2) (15) O and PET.In ten male patients with ARVC (mean age 49 ± 14 years), MBF was quantified at rest and during adenosine-induced hyperaemia using H (2) (15) O PET. Results were compared with those obtained in 20 age-matched healthy male control subjects (mean age 46 ± 14 years).Resting MBF was not significantly different between patients with ARVC and controls (MBF(rest) 1.19 ± 0.29 vs. 1.12 ± 0.20 ml/min/ml). However, hyperaemic MBF was significantly lower in patients with ARVC than in controls (2.60 ± 0.96 vs. 3.68 ± 0.84 ml/min/ml; p = 0.005). Consequently, patients with ARVC had a significantly lower coronary flow reserve than control subjects (2.41 ± 1.34 vs. 3.39 ± 0.93; p = 0.030). In addition, hyperaemic coronary vascular resistance was increased in patients with ARVC (36.79 ± 12.91 vs. 26.31 ± 6.49 mmHg × ml(-1) × min × ml; p = 0.007), but was found to be unchanged at rest.In this small well-characterized cohort of patients with nonfailing ARVC, we found a significantly reduced hyperaemic MBF and increased coronary vascular resistance. Further studies are necessary to corroborate this potential new functional aspect of the pathophysiological mechanisms underlying ARVC.

Details about the publication

JournalEuropean Journal of Nuclear Medicine and Molecular Imaging (Eur J Nucl Med Mol Imaging)
Volume39
Issue3
Page range416-420
StatusPublished
Release year2012
Language in which the publication is writtenEnglish

Authors from the University of Münster

Gerß, Joachim
Institute of Biostatistics and Clinical Research (IBKF)
Kies, Peter
Clinic for Nuclear Medicine
Rahbar, Kambiz
Clinic for Nuclear Medicine
Schäfers, Klaus
European Institute of Molecular Imaging (EIMI)
Schäfers, Michael
European Institute of Molecular Imaging (EIMI)
Schober, Otmar
Clinic for Nuclear Medicine