흡연자에서 관상동맥 내피세포 의존성 심근 혈류 예비능: H2 15O PET 찬물자극 검사에 의한 평가 (Evaluation of Endothelium-dependent Myocardial Perfusion Reserve in Healthy Smokers; Cold Pressor Test using H2 15O PET) |
Author |
황경훈, 이동수, 이병일, 이재성, 이호영, 정준기, 이명철, |
Kyung-Hoon Hwang, Dong Soo Lee, Byeong-Il Lee, Jae Sung Lee, Ho-Young Lee, |
Affiliation |
서울대학교 의과대학 핵의학교실, 가천의과대학 길병원 핵의학과 Department of Nuclear Medicine1, Seoul National University College of Medicine, Seoul, Korea and |
Abstract |
Purpose: Much evidence suggests long-term cigarette smoking alters coronary vascular endothelial
response. In this study, we applied nonnegative matrix factorization (NMF), an unsupervised learning
algorithm, to CO-less H2
15O-PET to investigate coronary endothelial dysfunction caused by smoking
noninvasively. Materials and methods: This study enrolled eighteen young male volunteers consisting of
9 smokers (23.8±1.1 yr; 6.6±2.5 pack-years) and 9 nonsmokers (23.8±2.9 yr). They do not have any
cardiovascular risk factor or disease history. Myocardial H2
15O-PET was performed at rest, during cold (5℃)
pressor stimulation and during adenosine infusion. Left ventricular blood pool and myocardium were
segmented on dynamic PET data by NMF method. Myocardial blood flow (MBF) was calculated from input
and tissue functions by a single compartmental model with correction of partial volume and spillover effects.
Results: There were no significant difference in resting MBF between the two groups (Smokers: 1.43 0.41
ml/g/min and non-smokers: 1.37±0.41 ml/g/min; p = NS). during cold pressor stimulation, MBF in smokers
was significantly lower than that in non-smokers (1.25±0.34 ml/g/min vs 1.59±0.29 ml/g/min ; p=0.019). The
difference in the ratio of cold pressor MBF to resting MBF between the two groups was also significant
(p=0.024; 90±24% in smokers and 122±28% in non-smokers.). During adenosine infusion, however,
hyperemic MBF did not differ significantly between smokers and non-smokers (5.81±1.99 ml/g/min vs 5.11
±1.31 ml/g/min ; p=NS). Conclusion: In smokers, MBF during cold pressor stimulation was significantly
lower compared with nonsmokers, reflecting smoking-induced endothelial dysfunction. However, there was
no significant difference in MBF during adenosine-induced hyperemia between the two groups. |
Keyword |
Cigarette smoking, H215O-PET, Cold pressor test, Endothelial dysfunction, Nonnegative matrix factorization |
Full text Article |
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