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Coronary endothelial dysfunction in patients with acute-onset idiopathic dilated cardiomyopathy

M A Mathier1, G A Rose, M A Fifer

  • 1Cardiac Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, USA.

Journal of the American College of Cardiology
|July 21, 1998
PubMed

Insights

Coronary endothelial dysfunction is present in acute dilated cardiomyopathy (DCM) and impacts left ventricular function recovery. Preserved endothelial function in DCM patients correlates with improved ejection fraction.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Heart Failure Research

Background:

  • Coronary endothelial dysfunction is known in chronic dilated cardiomyopathy (DCM).
  • Its role in the development and progression of ventricular dysfunction in acute DCM is unclear.
  • This study investigates endothelial function in acute idiopathic DCM and its link to left ventricular function recovery.

Purpose of the Study:

  • To determine the presence of coronary endothelial dysfunction in patients with acute-onset idiopathic DCM.
  • To explore the relationship between coronary endothelial function and the recovery of left ventricular systolic function in these patients.

Main Methods:

  • Assessed coronary endothelial function in 10 acute DCM patients and 11 controls using intracoronary acetylcholine and adenosine.
  • Measured coronary cross-sectional area (CSA) via quantitative coronary angiography and coronary blood flow (CBF) using Doppler catheter.
  • Evaluated left ventricular ejection fraction (LVEF) before and after the study period in DCM patients.

Main Results:

  • Acetylcholine caused epicardial constriction in DCM patients, unlike controls, indicating endothelial dysfunction.
  • DCM patients showed no increase in CBF with acetylcholine, while controls had significant increases.
  • A positive correlation was found between acetylcholine-induced coronary responses (CSA and CBF) and subsequent LVEF improvement in DCM patients.

Conclusions:

  • Acute-onset idiopathic DCM involves coronary endothelial dysfunction at both microvascular and epicardial levels.
  • Preserved coronary endothelial function in this patient group is associated with improved left ventricular function.
Abstract

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