Myocardial sympathetic innervation in diabetic patients with symptomatic coronary artery disease

被引：3

作者：

Fricke, E. ^{[1
]}

Eckert, S. ^{[2
]}

Fricke, H. ^{[1
]}

Koerfer, J. ^{[1
]}

Weisel, R. ^{[1
]}

Lindner, O. ^{[1
]}

Tschoepe, D. ^{[3
]}

Horstkotte, D. ^{[2
]}

Burchert, W. ^{[1
]}

机构：

[1] Hertz & Diabet Zentrum Nordrhein Westfalen, Inst Radiol Nukl Med & Mol Bildgebung, D-32545 Bad Oeynhausen, Germany

[2] Hertz & Diabet Zentrum Nordrhein Westfalen, Dept Cardiol, D-32545 Bad Oeynhausen, Germany

[3] Hertz & Diabet Zentrum Nordrhein Westfalen, Ctr Diabet, D-32545 Bad Oeynhausen, Germany

来源：

NUKLEARMEDIZIN-NUCLEAR MEDICINE | 2008年 / 47卷 / 01期

关键词：

diabetes mellitus; coronary heart disease; sympathetic nervous system; ischoemia; positron emission tomography;

D O I：

10.3413/nukmed-0102

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Aim: In non-diabetic patients, sympathetic innervation can be preserved even if there is major impairment of myocardial blood supply. Matters may be more complex in diabetic patients because denervation can be caused by (cardiac autonomic neuropathy (CAN) or by ischemic injury. Our aim was to determine whether restrictions in myocardial blood supply have a pronounced influence on sympathetic innervation in diabetics and if this effect can be differentiated from CAN. Patients, methods: We analyzed 20 diabetics with advanced coronary artery disease (CAD) and without known CAN. We determined quantitative myocardial blood flow using N-13-ammonia-PET, myocardial viability with F-18-FDG, and cardiac innervation with C-11-HED. We investigated the relationship between regional HED retention, blood flow, and coronary flow reserve (CFR). Attenuated heart rate response to adenosine was taken as indicator for CAN (HR ratio). Results: There was minor correlation of segmental stress flow and HED retention (r(2) = 0.063, p < 0.0001). Correlation improved when stress flow as well as HED retention were normalized to the individual maximum (r(2) = 0.162, p < 0.0001). In nine patients, a HR ratio < 1.2 implicated subdinical CAN. Duration of diabetic disease or glycaemic control (HbAlc) did not correlate with mean HED retention in the viable segments, but with its voriation coefficient. Conclusions: As in non-diabetic patients, a slight correlation exists between CFR and sympathetic innervation. The sensitivity of sympathetic nerves to reductions in CFR does not seem to be increased as compared to the results reported for non-diabetics. Besides impaired blood supply, long duration of diabetic disease and bad glycaemic control also seem to impair sympathetic innervation provoking higher heterogeneity.

引用

页码：24 / 29

页数：6