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Autonomic Imaging: The Cardiorenal Axis

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Autonomic Innervation of the Heart

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Abstract

In this chapter, we discuss the pathophysiology of the various chronic cardiorenal interactions and their consequences on the sympathetic nervous system (SNS). Increased activity of SNS is observed in all stages of chronic renal disease. The chronic elevation of SNS activity is a major contributor of the complex pathophysiology of hypertension, heart failure, insulin resistance, sleep disorders, diuretic resistance, and progressive kidney disease. Overactivity of SNS contributes to the high incidence of cardiovascular events and cardiac mortality, especially in patients with end-stage renal failure. The dysfunction of sympathetic innervation can be visualized directly by use of [123I]-metaiodobenzylguanidine ([123I]-MIBG) scintigraphy.

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Abbreviations

[123I]-MIBG:

[123I]-Metaiodobenzylguanidine

CKD:

Chronic kidney disease

CRS:

Cardiorenal syndromes

CSNS:

Cardiac sympathetic nervous system

CV:

Cardiovascular

ESRD:

End-stage renal disease

GFR:

Glomerular filtration rate

H/M:

Heart to mediastinum ratio

HF:

Heart failure

HRV:

Heart rate variability

IDH:

Intradialytic hypotension and dialytic hypotension

MBF:

Myocardial blood flow

NE:

Norepinephrine

NET:

Norepinephrine transporter protein

RAS:

Renin-angiotensin system

RRT:

Renal replacement therapy

RWMA:

Regional wall motion abnormality

SCD:

Sudden cardiac death

WR:

Washout rate

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Authors and Affiliations

  1. Department of Nuclear Medicine, Medical University of Lublin, Jaczewskiego 8c, Lublin, 20-954, Poland

    Beata E. Chrapko

  2. Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, The Netherlands

    Casper F. M. Franssen

Authors
  1. Beata E. Chrapko
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  2. Casper F. M. Franssen
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Correspondence to Beata E. Chrapko .

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Editors and Affiliations

  1. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Riemer H.J.A. Slart

  2. Thorax center Cardiology, University Medical Center Groningen, Groningen, The Netherlands

    René A. Tio

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Philip H. Elsinga

  4. Nuklearmedizinische Klinik, Klinikum Rechts der Isar Technische Universität München, München, Germany

    Markus Schwaiger

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Chrapko, B.E., Franssen, C.F.M. (2015). Autonomic Imaging: The Cardiorenal Axis. In: Slart, R., Tio, R., Elsinga, P., Schwaiger, M. (eds) Autonomic Innervation of the Heart. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45074-1_20

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