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Saraste A, Ståhle M, Roivainen A, Knuuti J. Molecular Imaging of Heart Failure: An Update and Future Trends. Semin Nucl Med 2024; 54:674-685. [PMID: 38609753 DOI: 10.1053/j.semnuclmed.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Abstract
Molecular imaging can detect and quantify pathophysiological processes underlying heart failure, complementing evaluation of cardiac structure and function with other imaging modalities. Targeted tracers have enabled assessment of various cellular and subcellular mechanisms of heart failure aiming for improved phenotyping, risk stratification, and personalized therapy. This review outlines the current status of molecular imaging in heart failure, accompanied with discussion on novel developments. The focus is on radionuclide methods with data from clinical studies. Imaging of myocardial metabolism can identify left ventricle dysfunction caused by myocardial ischemia that may be reversible after revascularization in the presence of viable myocardium. In vivo imaging of active inflammation and amyloid deposition have an established role in the detection of cardiac sarcoidosis and transthyretin amyloidosis. Innervation imaging has well documented prognostic value in predicting heart failure progression and arrhythmias. Tracers specific for inflammation, angiogenesis and myocardial fibrotic activity are in earlier stages of development, but have demonstrated potential value in early characterization of the response to myocardial injury and prediction of cardiac function over time. Early detection of disease activity is a key for transition from medical treatment of clinically overt heart failure towards a personalized approach aimed at supporting repair and preventing progressive cardiac dysfunction.
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Affiliation(s)
- Antti Saraste
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland; Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
| | - Mia Ståhle
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Anne Roivainen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
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2
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Slart RHJA, Bengel FM, Akincioglu C, Bourque JM, Chen W, Dweck MR, Hacker M, Malhotra S, Miller EJ, Pelletier-Galarneau M, Packard RRS, Schindler TH, Weinberg RL, Saraste A, Slomka PJ. Total-Body PET/CT Applications in Cardiovascular Diseases: A Perspective Document of the SNMMI Cardiovascular Council. J Nucl Med 2024:jnumed.123.266858. [PMID: 38388512 DOI: 10.2967/jnumed.123.266858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
Digital PET/CT systems with a long axial field of view have become available and are emerging as the current state of the art. These new camera systems provide wider anatomic coverage, leading to major increases in system sensitivity. Preliminary results have demonstrated improvements in image quality and quantification, as well as substantial advantages in tracer kinetic modeling from dynamic imaging. These systems also potentially allow for low-dose examinations and major reductions in acquisition time. Thereby, they hold great promise to improve PET-based interrogation of cardiac physiology and biology. Additionally, the whole-body coverage enables simultaneous assessment of multiple organs and the large vascular structures of the body, opening new opportunities for imaging systemic mechanisms, disorders, or treatments and their interactions with the cardiovascular system as a whole. The aim of this perspective document is to debate the potential applications, challenges, opportunities, and remaining challenges of applying PET/CT with a long axial field of view to the field of cardiovascular disease.
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Affiliation(s)
- Riemer H J A Slart
- Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;
- Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
| | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Cigdem Akincioglu
- Division of Nuclear Medicine, Medical Imaging, Western University, London, Ontario, Canada
| | - Jamieson M Bourque
- Departments of Medicine (Cardiology) and Radiology, University of Virginia, Charlottesville, Virginia
| | - Wengen Chen
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Edward J Miller
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut; Department of Radiology and Biomedical Imaging, Yale School of Medicine, and Department of Internal Medicine, Yale University, New Haven, Connecticut
| | | | - René R S Packard
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California
| | - Thomas H Schindler
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Cardiovascular Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Richard L Weinberg
- Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Antti Saraste
- Turku PET Centre and Heart Center, Turku University Hospital and University of Turku, Turku, Finland; and
| | - Piotr J Slomka
- Division of Artificial Intelligence in Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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3
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Kvitka D, Pauza DH. Pathways and morphologic pattern of blood supply of epicardial ganglionated nerve plexus. Ann Anat 2024; 252:152201. [PMID: 38128744 DOI: 10.1016/j.aanat.2023.152201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/29/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Detailed cardiac neuroanatomy is critical for understanding cardiac function and its pathology. However, there remains a significant gap in knowledge regarding the blood supply to the intrinsic cardiac ganglionated plexus (GP). This study addresses this by mapping the routes and morphological pattern of blood supply to the epicardial GP in a large-animal pig model (Sus scrofa domesticus). Twenty-five domestic pigs were used in the study. We demonstrate that the epicardial ganglionated nerves receive blood from both coronary and extra-cardiac arteries. The coronary arterial branches supply blood to all five subplexuses constituting the epicardial GP. In contrast, the branches of extra-cardiac arteries supply blood to target heart areas: 1) the venous part of the heart hilum on the left atrium, 2) the walls of the sinuses of the right cranial (superior cava) and 3) pulmonary veins. Uniformly, epicardial nerves and ganglia are supplied with blood via a sole epineurial arteriole which, in most cases, is the fifth/sixth-order branch of the coronary arteries. The extra-cardiac arteries supplying blood to the epicardial GP accompanied the mediastinal nerves entering the epicardium within the limits of the heart hilum. Together, the dual and triple blood supply of the epicardial nerves and ganglia suggests a protective role from an ischemic event and/or ischemic heart disease. STUCTURED ABSTRACT: This study details the anatomy of the blood supply of epicardial ganglionated nerve plexus, from which nerve fibres extend to the myocardium, heart conduction system, coronary vessels, and endocardium, in the most popular animal model of experimental cardiology and cardiac surgery - the domestic pig. Our observations demonstrate that the epicardial nerves and ganglia receive blood from both coronary and extra-cardiac arteries. The multi-source blood supply to the cardiac nerves and ganglia may offer protection against myocardial infarction ant other ischemic heart disorders.
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Affiliation(s)
- Dmitrij Kvitka
- Institute of Anatomy, Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus Street 9, Kaunas LT 44307, Lithuania.
| | - Dainius H Pauza
- Institute of Anatomy, Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickeviciaus Street 9, Kaunas LT 44307, Lithuania.
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4
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Filipović N, Marinović Guić M, Košta V, Vukojević K. Cardiac innervations in diabetes mellitus-Anatomical evidence of neuropathy. Anat Rec (Hoboken) 2023; 306:2345-2365. [PMID: 36251628 DOI: 10.1002/ar.25090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/09/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022]
Abstract
The extensive innervations of the heart include a complex network of sympathetic, parasympathetic, and sensory nerves connected in loops that serve to regulate cardiac output. Metabolic dysfunction in diabetes affects many different organ systems, including the cardiovascular system; it causes cardiac arrhythmias, silent myocardial ischemia, and sudden cardiac death, among others. These conditions are associated with damage to the nerves that innervate the heart, cardiac autonomic neuropathy (CAN), which is caused by various pathophysiological mechanisms. In this review, the main facts about the anatomy of cardiac innervations and the current knowledge of CAN, its pathophysiological mechanisms, and its diagnostic approach are discussed. In addition, anatomical evidence for CAN from human and animal studies has been summarized.
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Affiliation(s)
- Natalija Filipović
- Department of Anatomy, Histology and Embryology, Laboratory for Experimental Neurocardiology, University of Split School of Medicine, Split, Croatia
| | - Maja Marinović Guić
- Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia
- University Department of Health Studies, University of Split, Split, Croatia
| | - Vana Košta
- Department of Neurology, University Hospital of Split, Split, Croatia
| | - Katarina Vukojević
- Department of Anatomy, Histology and Embryology, Laboratory for Experimental Neurocardiology, University of Split School of Medicine, Split, Croatia
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Bansal A, Ananthasubramaniam K. Cardiovascular positron emission tomography: established and emerging role in cardiovascular diseases. Heart Fail Rev 2023; 28:387-405. [PMID: 36129644 DOI: 10.1007/s10741-022-10270-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 11/26/2022]
Abstract
Cardiac positron emission tomography (PET) imaging has established themselves firmly as excellent and reliable functional imaging modalities in assessment of the spectrum of coronary artery disease. With the explosion of technology advances and the dream of flow quantification now a reality, the value of PET is now well realized. Cardiac PET has proved itself as precise imaging modality that provides functional imaging of the heart in addition to anatomical imaging. It has established itself as one of the best available techniques for evaluation of myocardial viability. Hybrid PET/computed tomography provides simultaneous integration of coronary anatomy and function with myocardial perfusion and metabolism, thereby improving characterization of the dysfunctional area and chronic coronary artery disease. The availability of quantitative myocardial blood flow evaluation with PET provides additional prognostic information and increases diagnostic accuracy in the management of patients with coronary artery disease. Hybrid imaging seems to hold immense potential in optimizing management of cardiovascular diseases and furthering clinical research.
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Affiliation(s)
- Amit Bansal
- UHS Wilson Medical Center, Johnson City, NY, USA
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Verschure DO, Nakajima K, Verberne HJ. Cardiac 123I- mIBG Imaging in Heart Failure. Pharmaceuticals (Basel) 2022; 15:656. [PMID: 35745574 PMCID: PMC9230638 DOI: 10.3390/ph15060656] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 12/10/2022] Open
Abstract
Cardiac sympathetic upregulation is one of the neurohormonal compensation mechanisms that play an important role in the pathogenesis of chronic heart failure (CHF). In the past decades, cardiac 123I-mIBG scintigraphy has been established as a feasible technique to evaluate the global and regional cardiac sympathetic innervation. Although cardiac 123I-mIBG imaging has been studied in many cardiac and neurological diseases, it has extensively been studied in ischemic and non-ischemic CHF. Therefore, this review will focus on the role of 123I-mIBG imaging in CHF. This non-invasive, widely available technique has been established to evaluate the prognosis in CHF. Standardization, especially among various combinations of gamma camera and collimator, is important for identifying appropriate thresholds for adequate risk stratification. Interestingly, in contrast to the linear relationship between 123I-mIBG-derived parameters and overall prognosis, there seems to be a "bell-shape" curve for 123I-mIBG-derived parameters in relation to ventricular arrhythmia or appropriate implantable cardioverter defibrillator (ICD) therapy in patients with ischemic CHF. In addition, there is a potential clinical role for cardiac 123I-mIBG imaging in optimizing patient selection for implantation of expensive devices such as ICD and cardiac resynchronization therapy (CRT). Based on cardiac 123I-mIBG data risk models and machine learning, models have been developed for appropriate risk assessment in CHF.
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Affiliation(s)
- Derk O. Verschure
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location Amsterdam Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
- Department of Cardiology, Zaans Medical Center, Koningin Julianaplein 58, 1502 DV Zaandam, The Netherlands
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa 920-8641, Japan;
| | - Hein J. Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location Amsterdam Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
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7
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Wang JZ, Zelt JGE, Kaps N, Lavallee A, Renaud JM, Rotstein B, Beanlands RSB, Fallavollita JA, Canty JM, deKemp RA. Does quantification of [ 11C]meta-hydroxyephedrine and [ 13N]ammonia kinetics improve risk stratification in ischemic cardiomyopathy. J Nucl Cardiol 2022; 29:413-425. [PMID: 34341953 PMCID: PMC8807773 DOI: 10.1007/s12350-021-02732-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/13/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In ischemic cardiomyopathy patients, cardiac sympathetic nervous system dysfunction is a predictor of sudden cardiac arrest (SCA). This study compared abnormal innervation and perfusion measured by [11C]meta-hydroxyephedrine (HED) vs [13N]ammonia (NH3), conventional uptake vs parametric tracer analysis, and their SCA risk discrimination. METHODS This is a sub-study analysis of the prospective PAREPET trial, which followed ischemic cardiomyopathy patients with reduced left ventricular ejection fraction (LVEF ≤ 35%) for events of SCA. Using n = 174 paired dynamic HED and NH3 positron emission tomography (PET) scans, regional defect scores (%LV extent × severity) were calculated using HED and NH3 uptake, as well as HED distribution volume and NH3 myocardial blood flow by kinetic modeling. RESULTS During 4.1 years follow-up, there were 27 SCA events. HED defects were larger than NH3, especially in the lowest tertile of perfusion abnormality (P < .001). Parametric defects were larger than their respective tracer uptake defects (P < .001). SCA risk discrimination was not significantly improved with parametric or uptake mismatch (AUC = 0.73 or 0.70) compared to HED uptake defect scores (AUC = 0.67). CONCLUSION Quantification of HED distribution volume and NH3 myocardial blood flow produced larger defects than their respective measures of tracer uptake, but did not lead to improved SCA risk stratification vs HED uptake alone.
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Affiliation(s)
- Jean Z Wang
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Jason G E Zelt
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Nicole Kaps
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
| | - Aaryn Lavallee
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
| | - Jennifer M Renaud
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
- INVIA Medical Imaging Solutions, Ann Arbor, MI, USA
| | - Benjamin Rotstein
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Rob S B Beanlands
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - James A Fallavollita
- VA Western New York Healthcare System, Buffalo, NY, USA
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
| | - John M Canty
- VA Western New York Healthcare System, Buffalo, NY, USA
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
| | - Robert A deKemp
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
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8
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Ismailani US, Buchler A, Farber G, Pekošak A, Farber E, MacMullin N, Suuronen EJ, Vasdev N, Beanlands RSB, de Kemp RA, Rotstein BH. Cardiac Sympathetic Positron Emission Tomography Imaging with Meta-[ 18F]Fluorobenzylguanidine is Sensitive to Uptake-1 in Rats. ACS Chem Neurosci 2021; 12:4350-4360. [PMID: 34714061 DOI: 10.1021/acschemneuro.1c00575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Dysfunction of the cardiac sympathetic nervous system contributes to the development of cardiovascular diseases including ischemia, heart failure, and arrhythmias. Molecular imaging probes such as meta-[123I]iodobenzylguanidine have demonstrated the utility of assessing neuronal integrity by targeting norepinephrine transporter (NET, uptake-1). However, current radiotracers can report only on innervation due to suboptimal kinetics and lack sensitivity to NET in rodents, precluding mechanistic studies in these species. The objective of this work was to characterize myocardial sympathetic neuronal uptake mechanisms and kinetics of the positron emission tomography (PET) radiotracer meta-[18F]fluorobenzylguanidine ([18F]mFBG) in rats. Automated synthesis using spirocyclic iodonium(III) ylide radiofluorination produces [18F]mFBG in 24 ± 1% isolated radiochemical yield and 30-95 GBq/μmol molar activity. PET imaging in healthy rats delineated the left ventricle, with monoexponential washout kinetics (kmono = 0.027 ± 0.0026 min-1, Amono = 3.08 ± 0.33 SUV). Ex vivo biodistribution studies revealed tracer retention in the myocardium, while pharmacological treatment with selective NET inhibitor desipramine, nonselective neuronal and extraneuronal uptake-2 inhibitor phenoxybenzamine, and neuronal ablation with neurotoxin 6-hydroxydopamine reduced myocardial retention by 33, 76, and 36%, respectively. Clearance of [18F]mFBG from the myocardium was unaffected by treatment with uptake-1 and uptake-2 inhibitors following peak myocardial activity. These results suggest that myocardial distribution of [18F]mFBG in rats is dependent on both NET and extraneuronal transporters and that limited reuptake to the myocardium occurs. [18F]mFBG may therefore prove useful for imaging intraneuronal dysfunction in small animals.
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Affiliation(s)
- Uzair S. Ismailani
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Ariel Buchler
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, 10 Marie-Curie Private, Ottawa, Ontario K1N 6N5, Canada
| | - Gedaliah Farber
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | | | - Eadan Farber
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Nicole MacMullin
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Erik J. Suuronen
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Neil Vasdev
- Azrieli Centre for Neuro-Radiochemistry, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Rob S. B. Beanlands
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Robert A. de Kemp
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
| | - Benjamin H. Rotstein
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, 10 Marie-Curie Private, Ottawa, Ontario K1N 6N5, Canada
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9
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Gimelli A, Liga R, Agostini D, Bengel FM, Ernst S, Hyafil F, Saraste A, Scholte AJHA, Verberne HJ, Verschure DO, Slart RHJA. The role of myocardial innervation imaging in different clinical scenarios: an expert document of the European Association of Cardiovascular Imaging and Cardiovascular Committee of the European Association of Nuclear Medicine. Eur Heart J Cardiovasc Imaging 2021; 22:480-490. [PMID: 33523108 DOI: 10.1093/ehjci/jeab007] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/08/2021] [Indexed: 02/06/2023] Open
Abstract
Cardiac sympathetic activity plays a key role in supporting cardiac function in both health and disease conditions, and nuclear cardiac imaging has always represented the only way for the non-invasive evaluation of the functional integrity of cardiac sympathetic terminals, mainly through the use of radiopharmaceuticals that are analogues of norepinephrine and, in particular, with the use of 123I-mIBG imaging. This technique demonstrates the presence of cardiac sympathetic dysfunction in different cardiac pathologies, linking the severity of sympathetic nervous system impairment to adverse patient's prognosis. This article will outline the state-of-the-art of cardiac 123I-mIBG imaging and define the value and clinical applications in the different fields of cardiovascular diseases.
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Affiliation(s)
- Alessia Gimelli
- Department of Imaging, Fondazione Toscana/CNR Gabriele Monasterio1, via Moruzzi n.1, Pisa 56124, Italy
| | - Riccardo Liga
- Cardiac-Thoracic-Vascular Department, Università di Pisa, Pisa, Italy
| | - Denis Agostini
- Department of Nuclear Medicine, University Hospital of Normandy, CHU Cote de Nacre, Caen, France
| | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School (MHH), Hannover, Germany
| | - Sabine Ernst
- Royal Brompton and Harefield NHS Foundation Trust, National Heart and Lung Institute, Imperial College, London, UK
| | - Fabien Hyafil
- Department of Nuclear Medicine, European Hospital Georges-Pompidou, DMU IMAGINA, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Antti Saraste
- Turku PET Centre, University of Turku, Turku, Finland.,Heart Center, Turku University Hospital, Turku, Finland
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Derk O Verschure
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Cardiology, Zaans Medical Center, Zaandam, the Netherlands
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Centre, University Medical Center Groningen, Groningen, The Netherlands.,Faculty of Science and Technology, Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
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10
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Thackeray JT. The right stuff? Imaging cardiac sympathetic neuronal integrity of the right ventricle in pulmonary arterial hypertension. J Nucl Cardiol 2021; 28:423-426. [PMID: 33501548 DOI: 10.1007/s12350-020-02495-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 11/25/2022]
Affiliation(s)
- James T Thackeray
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg Str 1, D30625, Hannover, Germany.
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11
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Travin MI. Expanding the clinical potential of cardiac radionuclide adrenergic imaging. J Nucl Cardiol 2020; 27:2210-2215. [PMID: 30761479 DOI: 10.1007/s12350-019-01629-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Mark I Travin
- Division of Nuclear Medicine, Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 E. 210th Street, Bronx, NY, 10467-2490, USA.
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12
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Di Bona A, Vita V, Costantini I, Zaglia T. Towards a clearer view of sympathetic innervation of cardiac and skeletal muscles. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2020; 154:80-93. [DOI: 10.1016/j.pbiomolbio.2019.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/02/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023]
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13
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Bengel FM, Hermanns N, Thackeray JT. Radionuclide Imaging of the Molecular Mechanisms Linking Heart and Brain in Ischemic Syndromes. Circ Cardiovasc Imaging 2020; 13:e011303. [DOI: 10.1161/circimaging.120.011303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
For the heart and the brain, clinical observations suggest that an acute ischemic event experienced by one organ is associated with an increased risk for future acute events and chronic dysfunction of the reciprocal organ. Beyond atherosclerosis as a common systemic disease, various molecular mechanisms are thought to be involved in this interaction. Molecular-targeted nuclear imaging may identify the contribution of factors, such as the neurohumoral, circulatory, or especially the immune system, by combining specific radiotracers with whole-body acquisition and global as well as regional multiorgan analysis. This may be integrated with complementary functional imaging markers and systemic biomarkers for comprehensive network interrogation. Such systems-based strategies go beyond the traditional organ-centered approach and provide novel mechanistic insights, information about temporal dynamics, and a foundation for future interventions aiming at optimal preservation of function of both organs.
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Affiliation(s)
- Frank M. Bengel
- Department of Nuclear Medicine, Hannover Medical School, Germany
| | - Nele Hermanns
- Department of Nuclear Medicine, Hannover Medical School, Germany
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14
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Rijnierse MT, Groeneveldt JA, van Campen JSJA, de Boer K, van der Bruggen CEE, Harms HJ, Raijmakers PG, Lammertsma AA, Knaapen P, Bogaard HJ, Westerhof BE, Vonk Noordegraaf A, Allaart CP, de Man FS. Bisoprolol therapy does not reduce right ventricular sympathetic activity in pulmonary arterial hypertension patients. Pulm Circ 2020; 10:2045894019873548. [PMID: 32363028 PMCID: PMC7187746 DOI: 10.1177/2045894019873548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/29/2019] [Indexed: 11/27/2022] Open
Abstract
Right ventricular (RV) function and autonomic dysfunction are important
determinants of morbidity and mortality in patients with pulmonary arterial
hypertension (PAH). Although successful in animal studies, effects of
beta-blocker therapy on RV function in clinical trials were disappointing. To
understand this discrepancy, we studied whether beta-blocker therapy changes RV
sympathetic activity. Idiopathic PAH (IPAH) patients received beta-blocker
therapy (uptitrated to a maximal tolerated dose) and underwent cardiac magnetic
resonance imaging, right heart catheterization, and a
[11C]-hydroxyephedrine positron emission tomography
([11C]HED PET) scan at baseline to determine, respectively, RV
ejection fraction (RVEF), RV pressures, and sympathetic activity.
[11C]HED, a norepinephrine analogue, allows determination of
sympathetic innervation of the RV. [11C]HED retention index reflects
norepinephrine transporter activity. As a consequence of excessive catecholamine
levels in the synaptic cleft, this transporter may be downregulated. Therefore,
low [11C]HED retention index indicates high sympathetic activity. 13
IPAH patients underwent [11C]HED PET scans at baseline and after
bisoprolol treatment. Although heart rate was reduced, systemic modulation of
autonomic activity by bisoprolol did not affect local RV sympathetic nerve
activity, RV function, or RV wall tension. In PAH patients, RV
[11C]HED retention index was lower compared to LV tracer uptake
(p<0.01) and was related to systolic wall tension (R2 = 0.4731,
p<0.01) and RV function (R2 = 0.44, p = 0.01). In RV failure, the
tolerated dosage of bisoprolol did not result in an improvement of RV function
nor in a reduction in RV sympathetic activity.
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Affiliation(s)
- Mischa T Rijnierse
- Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joanne A Groeneveldt
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jasmijn S J A van Campen
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Karin de Boer
- Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Cathelijne E E van der Bruggen
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hendrik J Harms
- Radiology and Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pieter G Raijmakers
- Radiology and Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Adriaan A Lammertsma
- Radiology and Nuclear Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paul Knaapen
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Harm Jan Bogaard
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Berend E Westerhof
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Medical Biology, Section of Systems Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anton Vonk Noordegraaf
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Cornelis P Allaart
- Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Frances S de Man
- Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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15
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Tokuda Y, Sakakibara M, Yoshinaga K, Yamada S, Kamiya K, Asakawa N, Yoshitani T, Noguchi K, Manabe O, Tamaki N, Tsutsui H. Early therapeutic effects of adaptive servo-ventilation on cardiac sympathetic nervous function in patients with heart failure evaluated using a combination of 11C-HED PET and 123I-MIBG SPECT. J Nucl Cardiol 2019; 26:1079-1089. [PMID: 29181786 PMCID: PMC6660491 DOI: 10.1007/s12350-017-1132-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/31/2017] [Indexed: 02/05/2023]
Abstract
RATIONALE Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF. METHODS We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57.3 ± 17.3 years old, left ventricular ejection fraction (LVEF) 36.1 ± 16.7%]. We performed echocardiography, polysomnography, biomarkers, 11C-hydroxyephedrine (HED) PET as a presynaptic function marker and planar 123I-metaiodobenzylguanidine (MIBG) to evaluate washout rate. RESULTS ASV therapy reduced apnea-hypopnea index (AHI) and improved plasma brain natriuretic peptide (BNP) concentration. In 123I-MIBG imaging, the early heart/mediastinum (H/M) ratio increased after ASV therapy (2.19 ± 0.58 to 2.40 ± 0.67; P = 0.045). Washout rate did not change (23.8 ± 7.3% to 23.8 ± 8.8%; P = 0.122). Global 11C-HED retention index (RI) improved from 0.068 ± 0.033/s to 0.075 ± 0.034/s (P = 0.029). CONCLUSIONS ASV reduced AHI and improved BNP. ASV might initially improve presynaptic cardiac sympathetic nervous function in HF patients after 6 months of treatment.
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Affiliation(s)
- Yusuke Tokuda
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638 Japan
| | - Mamoru Sakakibara
- Department of Cardiovascular Medicine, Tokyo Tenshi Hospital, Tokyo, Japan
| | - Keiichiro Yoshinaga
- Diagnostic and Therapeutic Nuclear Medicine, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555 Japan
| | - Shiro Yamada
- Department of Cardiovascular Medicine, Otaru Kyokai Hospital, Otaru, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638 Japan
| | - Naoya Asakawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638 Japan
| | - Takashi Yoshitani
- Department of Cardiovascular Medicine, Hakodate Neurosurgery Hospital, Hakodate, Japan
| | - Keiji Noguchi
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638 Japan
| | - Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nagara Tamaki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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16
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17
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He Y, Zhang X, Liu J, Zhang J, Wang X. Radiosynthesis of β-phenylethylamine derivatives for cardiac sympathetic nervous PET imaging. J Radioanal Nucl Chem 2019. [DOI: 10.1007/s10967-018-06405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Affiliation(s)
- Frank M. Bengel
- Department of Nuclear Medicine, Hannover Medical School, Germany
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19
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Popescu CE, Cuzzocrea M, Monaco L, Caobelli F. Assessment of myocardial sympathetic innervation by PET in patients with heart failure: a review of the most recent advances and future perspectives. Clin Transl Imaging 2018. [DOI: 10.1007/s40336-018-0293-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Manabe O, Kikuchi T, Scholte AJHA, El Mahdiui M, Nishii R, Zhang MR, Suzuki E, Yoshinaga K. Radiopharmaceutical tracers for cardiac imaging. J Nucl Cardiol 2018; 25:1204-1236. [PMID: 29196910 PMCID: PMC6133155 DOI: 10.1007/s12350-017-1131-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 11/05/2017] [Indexed: 12/13/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disease burden worldwide. Nuclear myocardial perfusion imaging with either single-photon emission computed tomography or positron emission tomography has been used extensively to perform diagnosis, monitor therapies, and predict cardiovascular events. Several radiopharmaceutical tracers have recently been developed to evaluate CVD by targeting myocardial perfusion, metabolism, innervation, and inflammation. This article reviews old and newer used in nuclear cardiac imaging.
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Affiliation(s)
- Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tatsuya Kikuchi
- Department of Radiopharmaceutical Development, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, Chiba, Japan
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ryuichi Nishii
- Diagnostic and Therapeutic Nuclear Medicine, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan
| | - Ming-Rong Zhang
- Department of Radiopharmaceutical Development, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, Chiba, Japan
| | - Eriko Suzuki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Keiichiro Yoshinaga
- Diagnostic and Therapeutic Nuclear Medicine, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan.
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21
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Nakajima K, Matsunari I, Jacobson AF. I-123 metaiodobenzylguanidine innervation imaging as a tool for norepinephrine transporter research: A possible application for genetic analysis in heart failure. J Nucl Cardiol 2018; 25:907-910. [PMID: 27896701 DOI: 10.1007/s12350-016-0739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Kenichi Nakajima
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, 920-8641, Japan.
| | - Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, Saitama, Japan
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22
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Abstract
Imaging in heart failure (HF) provides data for diagnosis, prognosis and disease monitoring. Both MRI and nuclear imaging techniques have been successfully used for this purpose in HF. Positron Emission Tomography-Cardiac Magnetic Resonance (PET-CMR) is an example of a new multimodality diagnostic imaging technique with potential applications in HF. The threshold for adopting a new diagnostic tool to clinical practice must necessarily be high, lest they exacerbate costs without improving care. New modalities must demonstrate clinical superiority, or at least equivalence, combined with another important advantage, such as lower cost or improved patient safety. The purpose of this review is to outline the current status of multimodality PET-CMR with regard to HF applications, and determine whether the clinical utility of this new technology justifies the cost.
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Affiliation(s)
- Michael A Quail
- Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, Dana 3, P.O. Box 208017, New Haven, CT, 06520-8017, USA.,Institute of Cardiovascular Science, University College London, London, UK
| | - Albert J Sinusas
- Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, Dana 3, P.O. Box 208017, New Haven, CT, 06520-8017, USA. .,Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.
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23
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Liga R, Scholte AJHA. Neuro-cardiac imaging has a proven value in patient management: Con. J Nucl Cardiol 2017; 24:1583-1587. [PMID: 28593535 PMCID: PMC5629246 DOI: 10.1007/s12350-017-0947-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Riccardo Liga
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
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24
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Zheng PP, Li J, Kros JM. Breakthroughs in modern cancer therapy and elusive cardiotoxicity: Critical research-practice gaps, challenges, and insights. Med Res Rev 2017; 38:325-376. [PMID: 28862319 PMCID: PMC5763363 DOI: 10.1002/med.21463] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 12/16/2022]
Abstract
To date, five cancer treatment modalities have been defined. The three traditional modalities of cancer treatment are surgery, radiotherapy, and conventional chemotherapy, and the two modern modalities include molecularly targeted therapy (the fourth modality) and immunotherapy (the fifth modality). The cardiotoxicity associated with conventional chemotherapy and radiotherapy is well known. Similar adverse cardiac events are resurging with the fourth modality. Aside from the conventional and newer targeted agents, even the most newly developed, immune‐based therapeutic modalities of anticancer treatment (the fifth modality), e.g., immune checkpoint inhibitors and chimeric antigen receptor (CAR) T‐cell therapy, have unfortunately led to potentially lethal cardiotoxicity in patients. Cardiac complications represent unresolved and potentially life‐threatening conditions in cancer survivors, while effective clinical management remains quite challenging. As a consequence, morbidity and mortality related to cardiac complications now threaten to offset some favorable benefits of modern cancer treatments in cancer‐related survival, regardless of the oncologic prognosis. This review focuses on identifying critical research‐practice gaps, addressing real‐world challenges and pinpointing real‐time insights in general terms under the context of clinical cardiotoxicity induced by the fourth and fifth modalities of cancer treatment. The information ranges from basic science to clinical management in the field of cardio‐oncology and crosses the interface between oncology and onco‐pharmacology. The complexity of the ongoing clinical problem is addressed at different levels. A better understanding of these research‐practice gaps may advance research initiatives on the development of mechanism‐based diagnoses and treatments for the effective clinical management of cardiotoxicity.
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Affiliation(s)
- Ping-Pin Zheng
- Cardio-Oncology Research Group, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Pathology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jin Li
- Department of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Johan M Kros
- Department of Pathology, Erasmus Medical Center, Rotterdam, the Netherlands
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25
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Angelidis G, Giamouzis G, Karagiannis G, Butler J, Tsougos I, Valotassiou V, Giannakoulas G, Dimakopoulos N, Xanthopoulos A, Skoularigis J, Triposkiadis F, Georgoulias P. SPECT and PET in ischemic heart failure. Heart Fail Rev 2017; 22:243-261. [DOI: 10.1007/s10741-017-9594-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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26
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Yoshinaga K. Predicting cardiac events using ventricular dyssynchrony in patients who received implantable cardioverter defibrillators: Are more treatment options required? J Nucl Cardiol 2017; 24:130-133. [PMID: 26601672 DOI: 10.1007/s12350-015-0326-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Keiichiro Yoshinaga
- Molecular Imaging Research Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan.
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27
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Verschure DO, van Eck-Smit BLF, Somsen GA, Knol RJJ, Verberne HJ. Cardiac sympathetic activity in chronic heart failure: cardiac 123I-mIBG scintigraphy to improve patient selection for ICD implantation. Neth Heart J 2016; 24:701-708. [PMID: 27677744 PMCID: PMC5120011 DOI: 10.1007/s12471-016-0902-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Heart failure is a life-threatening disease with a growing incidence in the Netherlands. This growing incidence is related to increased life expectancy, improvement of survival after myocardial infarction and better treatment options for heart failure. As a consequence, the costs related to heart failure care will increase. Despite huge improvements in treatment, the prognosis remains unfavourable with high one-year mortality rates. The introduction of implantable devices such as implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy (CRT) has improved the overall survival of patients with chronic heart failure. However, after ICD implantation for primary prevention in heart failure a high percentage of patients never have appropriate ICD discharges. In addition 25–50 % of CRT patients have no therapeutic effect. Moreover, both ICDs and CRTs are associated with malfunction and complications (e. g. inappropriate shocks, infection). Last but not least is the relatively high cost of these devices. Therefore, it is essential, not only from a clinical but also from a socioeconomic point of view, to optimise the current selection criteria for ICD and CRT. This review focusses on the role of cardiac sympathetic hyperactivity in optimising ICD selection criteria. Cardiac sympathetic hyperactivity is related to fatal arrhythmias and can be non-invasively assessed with 123I-meta-iodobenzylguanide (123I-mIBG) scintigraphy. We conclude that cardiac sympathetic activity assessed with 123I-mIBG scintigraphy is a promising tool to better identify patients who will benefit from ICD implantation.
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Affiliation(s)
- D O Verschure
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Cardiology, Zaans Medical Center, Zaandam, The Netherlands.
| | - B L F van Eck-Smit
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - G A Somsen
- Cardiology Centres of the Netherlands, Amsterdam, The Netherlands
| | - R J J Knol
- Department of Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - H J Verberne
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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28
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Clinical Utility and Future Applications of PET/CT and PET/CMR in Cardiology. Diagnostics (Basel) 2016; 6:diagnostics6030032. [PMID: 27598207 PMCID: PMC5039566 DOI: 10.3390/diagnostics6030032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/17/2016] [Accepted: 08/23/2016] [Indexed: 12/15/2022] Open
Abstract
Over the past several years, there have been major advances in cardiovascular positron emission tomography (PET) in combination with either computed tomography (CT) or, more recently, cardiovascular magnetic resonance (CMR). These multi-modality approaches have significant potential to leverage the strengths of each modality to improve the characterization of a variety of cardiovascular diseases and to predict clinical outcomes. This review will discuss current developments and potential future uses of PET/CT and PET/CMR for cardiovascular applications, which promise to add significant incremental benefits to the data provided by each modality alone.
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29
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Travin MI. It's not all in the numbers. J Nucl Cardiol 2016; 23:436-41. [PMID: 25802176 DOI: 10.1007/s12350-015-0105-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 02/22/2015] [Indexed: 01/08/2023]
Affiliation(s)
- Mark I Travin
- Division of Nuclear Medicine, Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 E. 210th Street, Bronx, NY, 10467-2490, USA.
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30
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Rijnierse MT, Allaart CP, Knaapen P. Principles and techniques of imaging in identifying the substrate of ventricular arrhythmia. J Nucl Cardiol 2016; 23:218-34. [PMID: 26667814 PMCID: PMC4785206 DOI: 10.1007/s12350-015-0344-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 11/10/2015] [Indexed: 01/26/2023]
Abstract
Life-threatening ventricular arrhythmias (VA) are a major cause of death in patients with cardiomyopathy. To date, impaired left ventricular ejection fraction remains the primary criterion for implantable cardioverter-defibrillator therapy to prevent sudden cardiac death. In recent years, however, advanced imaging techniques such as nuclear imaging, cardiac magnetic resonance imaging, and computed tomography have allowed for a more detailed evaluation of the underlying substrate of VA. These imaging modalities have emerged as a promising approach to assess the risk of sudden cardiac death. In addition, non-invasive identification of the critical sites of arrhythmias may guide ablation therapy. Typical anatomical substrates that can be evaluated by multiple advanced imaging techniques include perfusion abnormalities, scar and its border zone, and sympathetic denervation. Understanding the principles and techniques of different imaging modalities is essential to gain more insight in their role in identifying the arrhythmic substrate. The current review describes the principles of currently available imaging techniques to identify the substrate of VA.
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Affiliation(s)
- Mischa T Rijnierse
- Department of Cardiology and Institute for Cardiovascular Research (IcaR-VU), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Cornelis P Allaart
- Department of Cardiology and Institute for Cardiovascular Research (IcaR-VU), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Paul Knaapen
- Department of Cardiology and Institute for Cardiovascular Research (IcaR-VU), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
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31
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Abstract
Determination of ventricular arrhythmic risk is crucial for guiding management of cardiac disease. Although for patients at increased risk an implantable cardioverter-defibrillator is recommended, it is widely acknowledged that current criteria for device use based predominantly on left ventricular ejection fraction are deficient. Genesis of ventricular arrhythmias involves a complex interaction of myocardial substrate abnormalities, precipitating triggers, and modulating factors. There are much data showing that by more directly assessing these factors, noninvasive imaging using echocardiography, radionuclide imaging, and cardiac magnetic resonance enhances arrhythmic risk stratification beyond ejection fraction and commonly used electrocardiographic and serum biomarkers. It is anticipated that further technological advancements studied in well-designed clinical trials will provide both more precise determination of risk and guide therapies to enhanced survival and patient well-being.
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Affiliation(s)
- Mark I Travin
- From the Division of Nuclear Medicine, Department of Radiology (M.I.T.) and Division of Cardiology, Department of Medicine (C.C.T), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; and Metropolitan Heart and Vascular Institute, Minneapolis, MN (D.F.).
| | - DaLi Feng
- From the Division of Nuclear Medicine, Department of Radiology (M.I.T.) and Division of Cardiology, Department of Medicine (C.C.T), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; and Metropolitan Heart and Vascular Institute, Minneapolis, MN (D.F.)
| | - Cynthia C Taub
- From the Division of Nuclear Medicine, Department of Radiology (M.I.T.) and Division of Cardiology, Department of Medicine (C.C.T), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; and Metropolitan Heart and Vascular Institute, Minneapolis, MN (D.F.)
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32
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Gupta S, Amanullah A. Radionuclide imaging of cardiac sympathetic innervation in heart failure: unlocking untapped potential. Heart Fail Rev 2015; 20:215-26. [PMID: 25135163 DOI: 10.1007/s10741-014-9456-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Heart failure (HF) is associated with sympathetic overactivity, which contributes to disease progression and arrhythmia development. Cardiac sympathetic innervation imaging can be performed using radiotracers that are taken up in the presynaptic nerve terminal of sympathetic nerves. The commonly used radiotracers are (123)I-metaiodobenzylguanidine ((123)I-mIBG) for planar and single-photon emission computed tomography imaging, and (11)C-hydroxyephedrine for positron emission tomography imaging. Sympathetic innervation imaging has been used in assessing prognosis, response to treatment, risk of ventricular arrhythmias and sudden death and prediction of response to cardiac resynchronization therapy in patients with HF. Other potential applications of these techniques are in patients with chemotherapy-induced cardiomyopathy, predicting myocardial recovery in patients with left ventricular assist devices, and assessing reinnervation following cardiac transplantation. There is a lack of standardization with respect to technique of (123)I-mIBG imaging that needs to be overcome for the imaging modality to gain popularity in clinical practice.
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Affiliation(s)
- Shuchita Gupta
- Einstein Institute for Heart and Vascular Health, Einstein Medical Center, 5501 Old York Road, 3rd Floor Levy Building, Philadelphia, PA, 19141, USA,
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33
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Role of the autonomic nervous system in activation of human brown adipose tissue: A review of the literature. DIABETES & METABOLISM 2015; 41:437-45. [DOI: 10.1016/j.diabet.2015.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/21/2015] [Accepted: 08/28/2015] [Indexed: 11/17/2022]
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34
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35
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11C-meta-hydroxyephedrine: a promising PET radiopharmaceutical for imaging the sympathetic nervous system. Clin Nucl Med 2015; 40:e96-e103. [PMID: 24999701 DOI: 10.1097/rlu.0000000000000512] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Dysfunction of the sympathetic nervous system underlies many cardiac diseases and can be assessed by molecular imaging using SPECT tracers as I-metaiodobenzylguanidine (I-MIBG). The norepinephrine analog C-meta-hydroxyephedrine (HED) has been used with PET to map the regional distribution of cardiac sympathetic neurons. Hydroxyephedrine is rapidly transported into sympathetic neurons by the norepinephrine transporter and stored in vesicles. This review describes the mechanism of action, radiosynthesis, and application of HED in the assessment of the cardiac sympathetic nervous system in heart failure, myocardial infarction, and arrhythmias. Noncardiac applications of HED in the clinical setting of sympathetic nervous system tumors and other emerging research applications are described.
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Yoshinaga K, Tamaki N. Current status of nuclear cardiology in Japan: Ongoing efforts to improve clinical standards and to establish evidence. J Nucl Cardiol 2015; 22:690-9. [PMID: 25896679 DOI: 10.1007/s12350-015-0136-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 11/25/2022]
Abstract
Nuclear cardiology imaging tests are widely performed in Japan as clinical practice. The Japanese nuclear cardiology community has developed new diagnostic imaging tests using (123)I-beta-methyl-p-iodophenyl-pentadecanoic acid, (123)I-metaiodobenzylguanidine, and (18)F-fluorodeoxyglucose PET for detecting cardiac involvement in sarcoidosis. These tests have become popular worldwide. The Japanese Circulation Society and the Japanese Society of Nuclear Cardiology have published clinical imaging guidelines showing indications and standards for the new imaging tests. JSNC is currently striving to improve the standard of clinical practice and is promoting research activities.
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Affiliation(s)
- Keiichiro Yoshinaga
- Molecular Imaging Research Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan,
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Chen X, Werner RA, Javadi MS, Maya Y, Decker M, Lapa C, Herrmann K, Higuchi T. Radionuclide imaging of neurohormonal system of the heart. Am J Cancer Res 2015; 5:545-58. [PMID: 25825596 PMCID: PMC4377725 DOI: 10.7150/thno.10900] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 01/02/2015] [Indexed: 12/18/2022] Open
Abstract
Heart failure is one of the growing causes of death especially in developed countries due to longer life expectancy. Although many pharmacological and instrumental therapeutic approaches have been introduced for prevention and treatment of heart failure, there are still limitations and challenges. Nuclear cardiology has experienced rapid growth in the last few decades, in particular the application of single photon emission computed tomography (SPECT) and positron emission tomography (PET), which allow non-invasive functional assessment of cardiac condition including neurohormonal systems involved in heart failure; its application has dramatically improved the capacity for fundamental research and clinical diagnosis. In this article, we review the current status of applying radionuclide technology in non-invasive imaging of neurohormonal system in the heart, especially focusing on the tracers that are currently available. A short discussion about disadvantages and perspectives is also included.
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Abstract
AIMS Elderly women with myocardial infarction (MI) show poorer outcomes than men. In patients with MI, reduced heart rate variability (HRV) is associated with an increased risk of mortality. Thus, we aimed to investigate HRV in elderly women with MI. METHODS HRV indexes in women 50 years of age or older were compared to those in age-adjusted men with MI: geometric (triangular index), linear (low frequency [LF, ms(2)], high frequency [HF, ms(2)], standard deviation (SD) of normal R-R wave intervals [SDNN], square root of the mean of the sum of the squares of differences between adjacent normal R wave intervals [RMSSD]) and nonlinear Poincaré analysis [SD1 and SD2, ms]. RESULTS Women had higher MI recurrence than men (11% vs. 5% with two MIs; 6% vs. 1% with three MIs). Overall HRV, the triangular index and SDNN were considerably lower in women than men (3.1 [2.5-4.4] vs. 4.5 [3.2-5.9] and 9.3 [6.9-15.8] vs. 19.2 [11.4-26.4] respectively; p < 0.001). Moreover, HRV indexes (HF, LF/HF, RMSSD, and SD1) were significantly lower in women (62.2%, 55.6%, 37.1%, and 37.2% respectively; p < 0.01). CONCLUSION This study suggests that elderly women with MI may have a worse prognosis than men, indicated by cardiac autonomic dysfunction. Since our study is cross-sectional and cannot infer causality, causation should be confirmed in further longitudinal studies.
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Affiliation(s)
- Andreia de Oliveira Pinheiro
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
| | - Valter Luis Pereira
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
| | - Ovidiu Constantin Baltatu
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
| | - Luciana Aparecida Campos
- a Center of Innovation, Technology and Education - (CITE), Camilo Castelo Branco University , Sao Jose dos Campos , Brazil
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Wollenweber T, Bengel FM. Molecular imaging to predict ventricular arrhythmia in heart failure. J Nucl Cardiol 2014; 21:1096-109. [PMID: 25138427 DOI: 10.1007/s12350-014-9975-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 08/04/2014] [Indexed: 11/25/2022]
Abstract
Ventricular tachycardia (VT) is a major cause of sudden cardiac death (SCD) in patients with heart failure (HF). Left ventricular ejection fraction (LVEF) and heart failure class according to the New York Heart association (NYHA) are in most common use to identify patients that may benefit from implantable cardioverter defibrillator (ICD) therapy. But during 3 years of follow up only 35% of patients receive appropriate ICD action. Therefore, there is a continued need for refinement of selection criteria for ICD implantation. In this regard, molecular imaging of the autonomic nervous system, which plays a central role in HF progression and cardiac electro-mechanical regulation, can make a substantial contribution. This article reviews the currently available literature concerning the value of molecular neuronal cardiac imaging for prediction of ventricular arrhythmias in HF patients.
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Affiliation(s)
- Tim Wollenweber
- Department of Nuclear Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Sinusas AJ, Lazewatsky J, Brunetti J, Heller G, Srivastava A, Liu YH, Sparks R, Puretskiy A, Lin SF, Crane P, Carson RE, Lee LV. Biodistribution and radiation dosimetry of LMI1195: first-in-human study of a novel 18F-labeled tracer for imaging myocardial innervation. J Nucl Med 2014; 55:1445-51. [PMID: 24994931 DOI: 10.2967/jnumed.114.140137] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
UNLABELLED A novel (18)F-labeled ligand for the norepinephrine transporter (N-[3-bromo-4-(3-(18)F-fluoro-propoxy)-benzyl]-guanidine [LMI1195]) is in clinical development for mapping cardiac nerve terminals in vivo using PET. Human safety, whole-organ biodistribution, and radiation dosimetry of LMI1195 were evaluated in a phase 1 clinical trial. METHODS Twelve healthy subjects at 3 clinical sites were injected intravenously with 150-250 MBq of LMI1195. Dynamic PET images were obtained over the heart for 10 min, followed by sequential whole-body images for approximately 5 h. Blood samples were obtained, and heart rate, electrocardiogram, and blood pressure were monitored before and during imaging. Residence times were determined from multiexponential regression of organ region-of-interest data normalized by administered activity (AA). Radiation dose estimates were calculated using OLINDA/EXM. Myocardial, lung, liver, and blood-pool standardized uptake values were determined at different time intervals. RESULTS No adverse events due to LMI1195 were seen. Blood radioactivity cleared quickly, whereas myocardial uptake remained stable and uniform throughout the heart over 4 h. Liver and lung activity cleared relatively rapidly, providing favorable target-to-background ratios for cardiac imaging. The urinary bladder demonstrated the largest peak uptake (18.3% AA), followed by the liver (15.5% AA). The mean effective dose was 0.026 ± 0.0012 mSv/MBq. Approximately 1.6% AA was seen in the myocardium initially, remaining above 1.5% AA (decay-corrected) through 4 h after injection. The myocardium-to-liver ratio was approximately unity initially, increasing to more than 2 at 4 h. CONCLUSION These preliminary data suggest that LMI1195 is well tolerated and yields a radiation dose comparable to that of other commonly used PET radiopharmaceuticals. The kinetics of myocardial and adjacent organ activity suggest that cardiac imaging should be possible with acceptable patient radiation dose.
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Affiliation(s)
- Albert J Sinusas
- Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | | | | | - Gary Heller
- Morristown Medical Center, Morristown, New Jersey; and
| | - Ajay Srivastava
- Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Yi-Hwa Liu
- Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
| | | | | | - Shu-fei Lin
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - Paul Crane
- Lantheus Medical Imaging, North Billerica, Massachusetts
| | - Richard E Carson
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - L Veronica Lee
- Lantheus Medical Imaging, North Billerica, Massachusetts
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Imaging of Cardiac Autonomic Innervation with SPECT and PET. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-013-9242-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jang KS, Jung YW, Gu G, Koeppe RA, Sherman PS, Quesada CA, Raffel DM. 4-[18F]Fluoro-m-hydroxyphenethylguanidine: a radiopharmaceutical for quantifying regional cardiac sympathetic nerve density with positron emission tomography. J Med Chem 2013; 56:7312-23. [PMID: 23965035 PMCID: PMC4520396 DOI: 10.1021/jm400770g] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
4-[(18)F]Fluoro-m-hydroxyphenethylguanidine ([(18)F]4F-MHPG, [(18)F]1) is a new cardiac sympathetic nerve radiotracer with kinetic properties favorable for quantifying regional nerve density with PET and tracer kinetic analysis. An automated synthesis of [(18)F]1 was developed in which the intermediate 4-[(18)F]fluoro-m-tyramine ([(18)F]16) was prepared using a diaryliodonium salt precursor for nucleophilic aromatic [(18)F]fluorination. In PET imaging studies in rhesus macaque monkeys, [(18)F]1 demonstrated high quality cardiac images with low uptake in lungs and the liver. Compartmental modeling of [(18)F]1 kinetics provided net uptake rate constants Ki (mL/min/g wet), and Patlak graphical analysis of [(18)F]1 kinetics provided Patlak slopes Kp (mL/min/g). In pharmacological blocking studies with the norepinephrine transporter inhibitor desipramine (DMI), each of these quantitative measures declined in a dose-dependent manner with increasing DMI doses. These initial results strongly suggest that [(18)F]1 can provide quantitative measures of regional cardiac sympathetic nerve density in human hearts using PET.
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Affiliation(s)
- Keun Sam Jang
- Division of Nuclear Medicine, Department of Radiology, 2276 Medical Sciences I Building, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - Yong-Woon Jung
- Division of Nuclear Medicine, Department of Radiology, 2276 Medical Sciences I Building, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - Guie Gu
- Division of Nuclear Medicine, Department of Radiology, 2276 Medical Sciences I Building, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - Robert A. Koeppe
- Division of Nuclear Medicine, Department of Radiology, 2276 Medical Sciences I Building, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - Phillip S. Sherman
- Division of Nuclear Medicine, Department of Radiology, 2276 Medical Sciences I Building, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - Carole A. Quesada
- Division of Nuclear Medicine, Department of Radiology, 2276 Medical Sciences I Building, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - David M. Raffel
- Division of Nuclear Medicine, Department of Radiology, 2276 Medical Sciences I Building, University of Michigan Medical School, Ann Arbor, Michigan 48109
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Bengel FM, Thackeray JT. Altered cardiac innervation predisposes to ventricular arrhythmia: targeted positron emission tomography identifies risk in ischemic cardiomyopathy. J Am Coll Cardiol 2013; 63:150-2. [PMID: 24076279 DOI: 10.1016/j.jacc.2013.08.1629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 08/28/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Frank M Bengel
- Klinik für Nuklearmedizin, Medizinische Hochschule Hannover, Hannover, Germany.
| | - James T Thackeray
- Klinik für Nuklearmedizin, Medizinische Hochschule Hannover, Hannover, Germany
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Flotats A. Advances in Molecular Imaging: Innervation Imaging. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9209-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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