Myocardial beta-adrenoceptor down-regulation early after infarction is associated with long-term incidence of congestive heart failure.

Abstract:

AIMS:Adverse left ventricular (LV) remodelling after myocardial infarction (MI) frequently leads to congestive heart failure (CHF). We have previously shown that myocardial beta-adrenoceptor density (beta-ARD) is reduced soon after acute MI and correlates with LV dilatation in the short term. The aim of the present study was to determine whether myocardial beta-ARD measured early after MI was associated with progression to CHF in the long term. METHODS AND RESULTS:We prospectively included 61 consecutive patients (mean age, 52 +/- 11 years, 10 female) in whom MI was the first manifestation of coronary artery disease. Two to 4 weeks after MI, patients underwent positron emission tomography with S-[(11)C]CGP 12177 to measure beta-ARD and (15)O-labelled water to measure myocardial blood flow and coronary flow reserve. Patients were followed-up for a median of 12.7 years (interquartile range, 6.5-13.7 years) and incidence of CHF was recorded. Eleven patients (18%) developed CHF during follow-up. They had lower beta-ARD compared with those who did not (5.35 vs. 6.49 pmol/g, P < 0.001). In patients with myocardial beta-ARD < or =5.57 pmol/g, 10-year CHF incidence rates were higher than in patients with beta-ARD >5.57 pmol/g (57% vs. 9%, P < 0.001). In a Cox regression model, only whole-heart beta-ARD [hazard ratio (HR) 0.29; 95% confidence interval (CI), 0.15-0.58, P < 0.001] and beta-ARD in remote myocardium (HR 0.32; 95% CI, 0.16-0.61, P = 0.001) were significantly associated with the incidence of CHF at follow-up. CONCLUSION:Reduced myocardial beta-ARD early after MI is associated with the incidence of CHF on long-term follow-up.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Gaemperli O,Liga R,Spyrou N,Rosen SD,Foale R,Kooner JS,Rimoldi OE,Camici PG

doi

10.1093/eurheartj/ehq138

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

1722-9

issue

14

eissn

0195-668X

issn

1522-9645

pii

ehq138

journal_volume

31

pub_type

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