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Depressed recovery of subendocardial perfusion in persistent heart failure after complete revascularization in diabetic patients with hibernating myocardium
  1. Reiko Mizuno (rmizuno{at}naramed-u.ac.jp)
  1. Nara Medical University, Japan
    1. Shinichi Fujimoto (sfujimot{at}naramed-u.ac.jp)
    1. Nara Medical University, Japan
      1. Yoshihiko Saito
      1. Nara Medical University, Japan
        1. Shinobu Nakamura
        1. Nara Medical University, Japan

          Abstract

          Objectives: We investigated the relation between myocardial perfusion and heart failure (HF) status after revascularization in patients with HF due to hibernating myocardium (HM) in comparing diabetics and nondiabetics.

          Methods: We studied thirty-one diabetics and thirty-three nondiabetics with HF due to HM, who were already scheduled for complete revascularization. Before and after revascularization, left ventricular function and regional perfusion in subendocardial and subepicardial portions of left ventricular wall were evaluated.

          Results: Before revascularization, left ventricular function and regional perfusion were similar between diabetics and nondiabetics. At six months after revasularization, subepicardial perfusion was markedly improved similarly in diabetics and nondiabetics. However, subendocardial perfusion was markedly improved only in nondiabetics and was little changed in diabetics. Thus, subendocardial perfusion was much lower in diabetics than nondiabetics. Left ventricular function was improved more greatly in nondiabetics compared with diabetics. Persistent HF was found much more frequently in diabetics than nondiabetics. At multivariate analysis subendocardial perfusion at six months independently contributed to persistent HF.

          Conclusions: This is the first description about the intramural heterogeneity of recovery of myocardial perfusion with depressed improvement in subendocardial portion and its relation with persistent HF after complete revascularization in diabetics with HF due to HM.

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