Cardiac Sympathetic Denervation After Transmyocardial Laser Revascularization
作者： Thabet Al-Sheikh , Keith B. Allen , Susan P. Straka , David A. Heimansohn , Richard L. Fain
关键词: Revascularization 、 Perfusion 、 Angina 、 Ventricle 、 Transmyocardial revascularization 、 Electrical conduction system of the heart 、 Cardiology 、 Coronary circulation 、 Internal medicine 、 Medicine 、 Denervation
摘要: Background—Transmyocardial laser revascularization (TMR) has been shown to improve refractory angina not amenable conventional coronary interventions. However, the mechanism of action remains controversial, because improved myocardial perfusion consistently demonstrated. We hypothesized that TMR relieves by causing sympathetic denervation. Methods and Results—PET imaging resting stress with [13N]ammonia (NH3) innervation [11C]hydroxyephedrine (HED) was performed before after in 8 patients class IV ineligible for CABG or PTCA. A mean 50±11 channels were created left ventricle (LV) a holmium:YAG laser. semiautomated program used determine NH3 uptake HED retention LV. Perfusion defects defined as percentage LV tracer >2 SD below normal values. All experienced improvement their 2.4±0.5 angina...
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