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(Circulation. 2000;101:e205.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Endothelium-Dependent and -Independent Perfusion Reserve and the Effect of L-Arginine on Myocardial Perfusion in Patients With Syndrome X

Stuart D. Rosen, MA, MD, MRCP, FESC, FACC; Paolo G. Camici, MD, FRCP, FESC, FACC

MRC Cyclotron Unit, Imperial College School of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0NN, SDandA.Rosen@btinternet.com

	Introduction

 
To the Editor:

We read the recent article by Bøttcher et al¹ with interest. Unfortunately, the authors do not discuss their findings in the light of a previous study by our group.² This study is quite relevant to their work and was published in Circulation 5 years ago. In our experiment, we also used positron emission tomography to measure myocardial blood flow (MBF) at rest and after the administration of intravenous dipyridamole in patients with syndrome X (n=29) and in a substantial control group (n=20). Our principal finding was that no significant differences existed between patients and controls with respect to myocardial blood flow (Figure 1). With a broader range of controls, Bøttcher et al’s corresponding figure (Figure 2) would probably not be distinguishable from ours.

View larger version (25K): [in this window] [in a new window]   Figure 1. Graph shows myocardial blood flow at rest and after dipyridamole (Dip.) in syndrome X patients and normal control subjects. Reproduced with permission from Reference 2.

View larger version (28K): [in this window] [in a new window]   Figure 2. Resting myocardial blood flow in mL · g-1 · min-1 and hyperemic myocardial blood flow after infusion of dipyridamole (DIP) 0.56 mL · kg-1 · min-1 in patients with syndrome X (n=25) and normal controls (group A, age-matched [n=15]; group B, young [n=15]). *P<0.05 rest vs DIP; +P<0.05 vs control group A; ¤P<0.05 vs control group B. Reproduced with permission from Reference 1.

Although Bøttcher et al’s data are quite consistent with ours in a number of respects, their interpretation of the data is perplexing. For example, on 2 occasions in . . . [Full Text of this Article]

Morten Bøttcher, MD; Hans Erik Bøtker, MD, PhD; Helle Sonne, MD; Torsten Toftegaard Nielsen, MD; Johannes Czernin, MD

Department of Cardiology B, University Hospital of Aarhus (SKS), DK-8200 Aarhus N, Denmark