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Investigation of the relationship between regression of hypertensive cardiac hypertrophy and improvement of cardiac sympathetic nervous dysfunction using iodine-123 metaiodobenzylguanidine myocardial imaging

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Abstract

Although many theories exist on the subject, the mechanisms responsible for a reduction of hypertensive cardiac hypertrophy in response to antihypertensive therapy are still unclear. In order to investigate the relationship between regression of hypertensive cardiac hypertrophy and cardiac nervous function, we studied ten patients with untreated essential hypertension (six men and four women, 62±12 years old). Both echocardiography and iodine-123 metaiodobenzylguanidine (MIBG) myocardial imaging were performed before and after antihypertensive therapy. Left ventricular mass (LVM) was significantly reduced in conjunction with the reduction of blood pressure following treatment. MIBG myocardial images showed that the heart-to-mediastinum activity ratio (H/M) was significantly increased while the washout ratio was significantly decreased. Patients were divided into two groups according to the ratio of the LVM values before and after therapy (LVM ratio). Patients with an LVM ratio of less than 0.75 were classified as group A and those with values higher than 0.75 as group B. Neither the change in blood pressure nor the length of treatment was significantly different between these two groups. On the other hand, both the increase in H/M and the decrease in the washout ratio were significantly greater in group A than in group B. These results indicate that an improvement in cardiac sympathetic nervous function may be related to the regression of hypertensive cardiac hypertrophy. Increasing the subject base in these studies and a more precise analysis of the relevance of the data obtained from MIBG myocadial images are recommended to clarify how changes in cardiac sympathetic nervous function relate to the regression of hypertensive cardiac hypertrophy.

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References

  1. Sasayama S, Ross J Jr, Franklin D, Bloor CM, Bishop S, Dilley RB. Adaptations of the left ventricle to chronic pressure overload.Circ Res 1976; 38: 172–178.

    Google Scholar 

  2. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study.N Engl J Med 1990; 322: 1561–1566

    Google Scholar 

  3. Dahloef B, Pennert K, Hansson L. Reversal of left ventricular hypertrophy in hypertensive patients. A metaanalysis of 109 treatment studies.Am J Hypertens 1992; 5: 95–110.

    Google Scholar 

  4. Sisson JC, Wieland DM, Sherman P, Mangner TJ, Tobes MC, Jacques S Jr. Metaiodobenzylguanidine as an index of the adrenergic nervous system integrity and function.J Nucl Med 1987; 28: 1620–1624.

    Google Scholar 

  5. Jaques S Jr, Tobes MC, Sisson JC, Baker JA, Wieland DM. Comparison of the sodium dependency of uptake of metaiodobenzylguanidine and norepinephrine into cultured bovine adrenomedullary cells.Mol Pharmacol 1984; 26: 539–546

    Google Scholar 

  6. Wieland DM, Brown LE, Tobes MC, Rogers WL, Marsh DD, Mangner TJ, Swanson DP, Beierwaltes WH. Imaging the primate adrenal medullae with [123I] and [131I] meta-iodobenzylguanidine: concise communication.J Nucl Med 1981; 22: 358–364.

    Google Scholar 

  7. Gasnier B, Roisin MP, Scherman D, Coornaert S, Desplanches G, Henry JP. Uptake of meta-iodobenzylguanidine by bovine chromaffln granule membranes.Mol Pharmacol 1986; 29: 275–280.

    Google Scholar 

  8. Jaques S Jr, Tobes MC. Comparison of the secretary mechanisms of metaiodobenzylguanidine (MIBG) and norepinephrine (NE) from cultured bovine adrenomedullary cells.J Nucl Med 1985; 26: 17.

    Google Scholar 

  9. Kline RC, Swanson DP, Wieland DM. Myocardial imaging in man with I-123 meta-iodobenzylguanidine.J Nucl Med 1981; 22: 129–132.

    Google Scholar 

  10. Henderson EB, Kahn JK, Corbett JR, Jansen DE, Pippin JJ, Kulkarni P, Ugolini V, Akers MS, Hansen C, Buja LM, Parkey RW, Willerson JT. Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy.Circulation 1988; 78: 1192–1199.

    Google Scholar 

  11. Devereux RB, Reichek N. Echocardiographc determination of left ventricular mass in man; anatomic validation of the method.Circulation 1977; 55: 613–618.

    Google Scholar 

  12. Merlet P, Valette H, Dubous-Rande JL, Moyee D, Duboc D, Dove P, Bourguignon MH, Benvenuti C, Duval AM, Agostini D, Loisance D, Castaigne A, Syrota A. Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure.J Nucl Med 1992; 33: 471–477.

    Google Scholar 

  13. Dunn FG, Chandrarama P, deCarvalho JGR, Basta LL, Frohlich ED. Pathophysiologic assessment of hypertensive heart disease with echocardiography.Am J Cardiol 1977; 39: 789–795.

    Google Scholar 

  14. Dunn FG, Oigman W, Ventura HO, Messerli FH, Kobrin I, Frohlich ED. Enalapril improves systemic and renal hemodynamics and allows regression of left ventricular mass in essential hypertension.Am J Cardiol 1984; 53: 105–108.

    Google Scholar 

  15. Tan LB, Brilla C, Weber KT. Prevention of structural changes in the heart in hypertension by angiotensin converting enzyme inhibition.J Hypertens 1992; 10: 531–534

    Google Scholar 

  16. Arita M, Fujiwara S, Ueno Y, Shiotani M, Nakamura Y, Nakatsu C, Nishio I, Masuyama Y. Regression of left ventricular hypertrophy in hypertensive patients: responses to exercise by antihypertensive treatment.Jpn Circ J 1990; 54: 575–580.

    Google Scholar 

  17. Corea L, Bentivoglio M, Verdecchia P. Reversal of left ventricular hypertrophy in essential hypertension by early and long-term treatment with methyldopa.Clin Trial J 1981; 18: 380–394.

    Google Scholar 

  18. Corea L, Bentivoglio M, Verdecchia P, Motolese M. Plasma norepinephrine and left ventricular hypertrophy in systemic hypertension.Am J Cardiol 1984; 53: 1299–1303.

    Google Scholar 

  19. Simpson P. Norepinephrine-stimulated hypertrophy of cultured rat myocardial cells is an alpha 1 adrenergic response.J Clin Invest 1985; 74: 732–738.

    Google Scholar 

  20. Strauer BE, Mahmoud MA, Bayer F, Bohn I, Motz U. Reversal of left ventricular hypertrophy and improvement of cardiac function in man by nifedipine.Eur Heart J 1984; 5: 53–60.

    Google Scholar 

  21. Tsuchimochi S, Tamaka N, Tadamura E, Kawamoto M, Fujita T, Yonekura Y, Konishi J. Age and gender differences in normal myocardial adrenergic neuronal function evaluated by iodine-123-MIBG imaging.J Nucl Med 1995; 36: 969–974.

    Google Scholar 

  22. Schofer J, Spilmann R, Schucert A, Weber K, Schluter M. Iodine-123 metaiodobenzylguanidine scintigraphy: a noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy.J Am Coll Cardiol 1988; 119: 1252–1258.

    Google Scholar 

  23. Nakajima K, Bunko H, Taki J, Shimizu M, Muramori A, Hisada K. Quantitative analysis of123I-metaiodobenzylguanidine (MIBG) uptake in hypertrophic cardiomyopathy.Am Heart J 1990; 119: 1329–1337.

    Google Scholar 

  24. Gill JS, Hunter GJ, Gane G, Camm AJ. Heterogeneity of the human myocardial sympathetic innervation: in vivo demonstration by iodine 123-labeled metaiodobenzylguanidine scintigraphy.Am Heart J 1993; 126: 390–398.

    Google Scholar 

  25. Thames MD, Klopfenstein HS, Abboud FM, Mark AL, Walker JL. Preferential distribution of inhibitory cardiac receptors with vagal afferents to the inferoposterior wall of the left ventricle activated coronary occlusion in the dog.Circ Res 1978; 43: 512–519.

    Google Scholar 

  26. Khafagi FA, Shapiro B, Fig LM, Mallette S, Sisson JC. Labetalol reduces iodine-131 MIBG uptake by pheochromocytoma and normal tissues.J Nucl Med 1989; 30: 481–489.

    Google Scholar 

  27. Solanki KK, Bomanji J, Moyes J, Mather SJ, Trainer PJ, Britton KE. A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG).Nucl Med Commun 1992; 13: 513–521.

    Google Scholar 

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Morimoto, S., Terada, K., Keira, N. et al. Investigation of the relationship between regression of hypertensive cardiac hypertrophy and improvement of cardiac sympathetic nervous dysfunction using iodine-123 metaiodobenzylguanidine myocardial imaging. Eur J Nucl Med 23, 756–761 (1996). https://doi.org/10.1007/BF00843703

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  • DOI: https://doi.org/10.1007/BF00843703

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