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Okabe Y, Murai H, Tokuhisa H, Hamaoka T, Mukai Y, Sugimoto H, Takashima SI, Kato T, Matsuo S, Usui S, Furusho H, Takamura M, Kaneko S. Renal iodine 123-metaiodobenzylguanidine scintigraphy relates to muscle sympathetic nervous activity in heart failure with reduced ejection fraction. Auton Neurosci 2020; 226:102671. [PMID: 32272358 DOI: 10.1016/j.autneu.2020.102671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/29/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Renal denervation is effective for modulating augmented sympathetic nerve activity (SNA) in heart failure with reduced ejection fraction (HFrEF). We have demonstrated that renal iodine123-metaiodobenzylguanidine (123I-MIBG) scintigraphy is associated with muscle sympathetic nerve activity (MSNA) in patients with hypertension. However, it is unclear whether renal 123I-MIBG scintigraphy is useful for assessment of SNA in HFrEF. METHODS The study population consisted of 24 HFrEF patients and 11 healthy subjects as controls. Patients with HFrEF underwent 123I-MIBG scintigraphy and hemodynamics using a Swan-Ganz catheter (SGC). HFrEF was defined as echocardiography with left ventricular ejection fraction (LVEF) < 50%. MSNA was measured from the peroneal nerve for direct evaluation of SNA. Renal 123I-MIBG scintigraphy was performed simultaneously with cardiac scintigraphy. The early and delayed kidney-to-mediastinum ratio (K/M), early and delayed heart-to-mediastinum ratio (H/M), and washout rate (WR) were calculated. RESULTS LVEFs were 35% ± 11% in patients with HFrEF and 63% ± 10% in the controls (p < 0.01). The WR of cardiac 123I-MIBG showed no relation to MSNA, but was related to stroke volume (r = 0.45, p < 0.05). In contrast, the WR of renal 123I-MIBG scintigraphy (average of both sides) showed a strong correlation with MSNA (BI, r = 0.70, p < 0.01; BF, r = 0.66, p < 0.01); however, no significant correlations were detected between renal 123I-MIBG scintigraphy and SGC results. CONCLUSIONS The WR of renal 123I-MIBG scintigraphy may reflect MSNA. Further studies are needed to clarify the relationship between renal 123I-MIBG imaging and renal SNA.
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Affiliation(s)
- Yoshitaka Okabe
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Hisayoshi Murai
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan.
| | - Hideki Tokuhisa
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Takuto Hamaoka
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Yusuke Mukai
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Hiroyuki Sugimoto
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Shin-Ichiro Takashima
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Takeshi Kato
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Shinro Matsuo
- Department of Nuclear Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Hiroshi Furusho
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Shuichi Kaneko
- Departments of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
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Liga R, Gimelli A, Marzullo P, Ambrosio G, Cameli M, Cerbai E, Coiro S, Emdin M, Marcucci R, Morrone D, Palazzuoli A, Petronio AS, Savino K, Padeletti L, Pedrinelli R. Myocardial 123I-metaiodobenzylguanidine imaging in hypertension and left ventricular hypertrophy. J Nucl Cardiol 2018; 25:461-470. [PMID: 28798990 DOI: 10.1007/s12350-017-1029-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 07/28/2017] [Indexed: 10/19/2022]
Abstract
Sympathetic nervous system plays a pivotal role in essential hypertension and in the development of left ventricular hypertrophy. Moreover, cardiac sympathetic dys-regulation has been demonstrated as a key con-causal factor in the genesis and progression of pathologic conditions such as congestive heart failure and ischemic heart disease to which hypertension predisposes as a risk factor. However, despite its fundamental role in cardiac pathophysiology, the evaluation of cardiac sympathetic nervous system has never gained a wide clinical application, remaining mostly a research tool. In this context, nuclear imaging techniques are the only modalities to allow the direct evaluation of cardiac sympathetic nervous integrity, giving the chance to obtain objective measures of the sympathetic tone. This review, while summarizing the general profile of currently available tests for autonomic evaluation, focuses on 123I-metaiodobenzylguanidine nuclear imaging as a preferential tool to assess cardiac sympathetic status. Specifically, the review discusses the available evidence on cardiac 123I-metaiodobenzylguanidine scintigraphy in arterial hypertension and left ventricular hypertrophy and its diagnostic and prognostic potential in congestive heart failure and ischemic heart disease.
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Affiliation(s)
- Riccardo Liga
- Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa Medica, 56100, Pisa, Italy.
| | | | - Paolo Marzullo
- Fondazione Toscana G. Monasterio, Pisa, Italy
- Istituto di Fisiologia Clinica, CNR, Pisa, Italy
| | - Giuseppe Ambrosio
- Dipartimento di Medicina, Sezione di Cardiologia e Fisiopatologia Cardiovascolare, Università di Perugia, Perugia, Italy
| | - Matteo Cameli
- Dipartimento di Biotecnologie Mediche, Cardiologia Universitaria, Università di Siena, Siena, Italy
| | - Elisabetta Cerbai
- Dipartimento di Neuroscienze, Area del Farmaco e Salute del Bambino (NEUROFARBA), Università di Firenze, Florence, Italy
| | - Stefano Coiro
- Dipartimento di Medicina, Sezione di Cardiologia e Fisiopatologia Cardiovascolare, Università di Perugia, Perugia, Italy
| | | | - Rossella Marcucci
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Florence, Italy
| | - Doralisa Morrone
- Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa Medica, 56100, Pisa, Italy
| | | | - Anna Sonia Petronio
- Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa Medica, 56100, Pisa, Italy
| | - Ketty Savino
- Dipartimento di Medicina, Sezione di Cardiologia e Fisiopatologia Cardiovascolare, Università di Perugia, Perugia, Italy
| | - Luigi Padeletti
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Florence, Italy
- IRCCS Multimedica, Milan, Italy
| | - Roberto Pedrinelli
- Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa Medica, 56100, Pisa, Italy
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Gusso S, Pinto TE, Baldi JC, Robinson E, Cutfield WS, Hofman PL. Diastolic function is reduced in adolescents with type 1 diabetes in response to exercise. Diabetes Care 2012; 35:2089-94. [PMID: 22773700 PMCID: PMC3447841 DOI: 10.2337/dc11-2331] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether adolescents with type 1 diabetes have left ventricular functional changes at rest and during acute exercise and whether these changes are affected by metabolic control and diabetes duration. RESEARCH DESIGN AND METHODS The study evaluated 53 adolescents with type 1 diabetes and 22 control adolescents. Baseline data included peak exercise capacity and body composition by dual-energy X-ray absorptiometry. Left ventricular functional parameters were obtained at rest and during acute exercise using magnetic resonance imaging. RESULTS Compared with nondiabetic control subjects, adolescents with type 1 diabetes had lower exercise capacity (44.7 ± 09 vs. 48.5 ± 1.4 mL/kg fat-free mass [FFM]/min; P < 0.05). Stroke volume was reduced in the diabetes group at rest (1.86 ± 0.04 vs. 2.05 ± 0.07 mL/kg FFM; P = 0.02) and during acute exercise (1.89 ± 0.04 vs. 2.17 ± 0.06 mL/kg FFM; P = 0.01). Diabetic adolescents also had reduced end-diastolic volume at rest (2.94 ± 0.06 vs. 3.26 ± 0.09 mL/kg FFM; P = 0.01) and during acute exercise (2.78 ± 0.05 vs. 3.09 ± 0.08 mL/kg FFM; P = 0.01). End-systolic volume was lower in the diabetic group at rest (1.08 ± 0.03 vs. 1.21 ± 0.04 mL/kg FFM; P = 0.01) but not during acute exercise. Exercise capacity and resting and exercise stroke volumes were correlated with glycemic control but not with diabetes duration. CONCLUSIONS Adolescents with type 1 diabetes have reduced exercise capacity and display alterations in cardiac function compared with nondiabetic control subjects, associated with reduced stroke volume during exercise.
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Affiliation(s)
- Silmara Gusso
- Liggins Institute, University of Auckland, Auckland, New Zealand.
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