Myocardial fatty acid utilisation during exercise induced ischemia in patients with coronary artery disease

K. S. Virtanen; P. Nikkinen; L. Lindroth; J. T. Kuikka

doi:10.1055/s-0038-1623885

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2002; 41(03): 157-161
DOI: 10.1055/s-0038-1623885

Original Article

Schattauer GmbH

Myocardial fatty acid utilisation during exercise induced ischemia in patients with coronary artery disease

Fettsäureverwertung im Myokard bei belastungsinduzierter Ischämie bei Patienten mit Koronarinsuffizienz

K. S. Virtanen

¹First Department of Medicine, Kuopio, Finland

,

P. Nikkinen

²Department of Clinical Chemistry, Helsinki University Central Hospital, Kuopio, Finland

,

L. Lindroth

³Medix Diacor Laboratory Services, Ltd., Espoo, Kuopio, Finland

,

J. T. Kuikka

⁴Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Kuopio and Niuvanniemi Hospital, Kuopio, Finland

› Author Affiliations

Abstract

Summary

Aim: Reversible or irreversible myocardial damage due to ischemia correlates with altered membrane functions of the cells. To compare myocardial free fatty acid (FFA) metabolism and flow during exercise induced ischemia we studied ten patients with coronary artery disease but without previous myocardial infarction. Methods: A series of post-exercise single-photon emission computed tomography (SPECT) measurements was performed after injection of ¹²³I labelled heptadecanoic acid (HDA). Myocardial perfusion was estimated from the separately performed exercise-redistribution thallium study. Fatty acid metabolic rate, thallium uptake and washout were calculated for anterior, lateral, posterior and septal segments. Results: The more reduced post-exercise FFA metabolic rate (–63 ±18%, mean ±1 SD) compared to flow (–36 ±16%) was related to the severity of myocardial ischemia and wall motion abnormalities. Conclusion: In this small group of patients, the reduced post-exercise FFA metabolic rate tentatively suggests a parsimonious workload of the exercising myocardium by reducing oxygen consumption in patients with coronary artery disease.

Zusammenfassung

Ziel: Bei reversibler und irreversibler Myokardschädigung infolge Ischämie sind die Membranfunktionen der Zellen verändert. Um myokardialen Metabolismus freier Fettsäuren (FFA) und Durchblutung bei belastungsinduzierter Ischämie zu vergleichen, untersuchten wir zehn Patienten mit Koronarinsuffizienz, aber ohne vorangegangenen Myokardinfarkt. Methoden: Nach Injektion von ¹²³I-markierter Heptadekansäure (HDA) wurde eine Serie von SPECT-Messungen nach Belastung aufgenommen. Die myokardiale Perfusion wurde abgeschätzt durch die separat durchgeführte Thalliumverteilungsstudie nach Belastung. Fettsäurestoffwechsel, Thallium-Up-take und -Washout wurden für die anterioren, posterioren und septalen Segmente berechnet. Ergebnisse: Eine eingeschränktere FFA-Stoffwechselrate (–63 ±18%, ±1 SD) verglichen mit der Durchblutung (-–36 ±16%) steht im Zusammenhang mit dem Ausmaß der myokardialen Ischämie und abnormen Wandbewegungen. Schlussfolgerung: Für diese kleine Patientengruppe gilt, dass eine reduzierte FFA-Stoffwechselrate die spärliche Arbeitslast des unter Belastung stehenden Myokards andeutet als Folge eingeschränkten Sauerstoffverbrauchs bei Patienten mit Koronarinsuffizienz.

Keywords

Coronary artery disease - fatty acids - ischemia

Schlüsselwörter

Koronarinsuffizienz - Fettsäuremetabolismus - Ischämie

Full Text

References

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