Angiotensin-converting enzyme inhibition improves cardiac fatty acid metabolism in patients with congestive heart failure

被引：17

作者：

Yamauchi, S ^{[1
]}

Takeishi, Y ^{[1
]}

Minamihaba, O ^{[1
]}

Arimoto, T ^{[1
]}

Hirono, O ^{[1
]}

Takahashi, H ^{[1
]}

Miyamoto, T ^{[1
]}

Nitobe, J ^{[1
]}

Nozaki, N ^{[1
]}

Tachibana, H ^{[1
]}

Watanabe, T ^{[1
]}

Fukui, A ^{[1
]}

Kubota, I ^{[1
]}

机构：

[1] Yamagata Univ, Sch Med, Dept Internal Med 1, Yamagata 9909585, Japan

来源：

NUCLEAR MEDICINE COMMUNICATIONS | 2003年 / 24卷 / 08期

关键词：

I-123-BMIPP; angiotensin-converting enzyme inhibitor; heart failure; metabolism;

D O I：

10.1097/01.mnm.0000084579.51410.69

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：

This study aimed to examine whether angiotensin-converting enzyme (ACE) inhibition improved cardiac fatty acid metabolism in patients with congestive heart failure (CHF). Myocardial I-123-beta-methyliodophenylpentaclecanoic acid (I-123-BMIPP) imaging was performed in 25 patients with CHF and in 10 control subjects. Myocardial I-123-BMIPP images were obtained 30 min and 4 h after tracer injection. The heart-to-mediastinum (H/M) ratio of I-123-BMIPP uptake and the washout rate of I-123-BMIPP from the myocardium were calculated. Patients were given enalapril for 6 months, and I-123-BMIPP imaging was repeated. H/M ratios on early and delayed images were lower in CHF patients than in normal controls (P<0.01). The washout rate of I-123-BMIPP from the myocardium was faster in CHF patients than in controls (P < 0.01). As the severity of the New York Heart Association (NYHA) functional class increased, the H/M ratio decreased and the washout rate increased. The washout rate of I-123-BMIPP was inversely correlated with left ventricular fractional shortening (R = - 0.62, P < 0.01). ACE inhibition with enalapril increased the H/M ratio on delayed images (P<0.05) and reduced the washout rate of I-123-BMIPP (P<0.05) in CHT patients. These data suggest that: (1) angiotensin II-mediated intracellular signalling activation may be a possible mechanism for the decreased myocardial uptake and enhanced washout of I-123-BMIPP in heart failure patients; and (2) the improvement in fatty acid metabolism by ACE inhibition may represent a new mechanism for the beneficial effect of this therapy in heart failure. ((C) 2003 Lippincott Williams & Wilkins).

引用

页码：901 / 906

页数：6