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Neuronal dysfunction in heart failure assessed by cardiac 123-iodine metaiodobenzylguanidine scintigraphy

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Abstract

In patients with chronic heart failure, increased sympathetic activity and cardiac sympathetic neuronal dysfunction are present and have been related to unfavourable clinical outcome. Modification of these alterations with the objective to improve prognosis has become an important aim of pharmacological therapy for these patients. A noninvasive technique to assess sympathetic neuronal function at the cardiac level may be valuable in evaluating newly developed therapeutic strategies. 123-iodine metaiodobenzylguanidine can be used visualize cardiac sympathetic nerve function and activity. Single photon emission computerized tomographic is preferred to planar scintigraphy since it does not depend on superposition of other anatomical structures and may allow assessment of regional cardiac 123-iodine metaiodobenzylguanidine uptake. Although the quantitation of cardiac uptake in these tomographic images has several limitations, the use of the left ventricular cavity as a reference, calibrated by the 123-iodine activity in a blood sample drawn at the time of acquisition, may have clinical applications, with respect to the evaluation of therapeutical intervention in patients with heart failure.

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Abbreviations

BS:

blood sample

CD:

count density

dP/dt:

change in pressure over time

[123I]:

123-iodine

Km :

affinity constant

MIBG:

metaiodobenzylguanidine

MBq :

mega Bequerel

SPECT:

single photon emission computerized tomography

Vm :

capacity constant

References

  1. Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, Simon AB, Rector T. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 1984; 311: 819–823.

    Google Scholar 

  2. Fisher ML, Gottlieb SS, Plotnick GD, Greenberg NL, Patten RD, Bennett SK, Hamilton BP. Beneficial effects of metoprolol in heart failure associated with coronary artery disease: a randomized trial. J Am Coll Cardiol 1994; 23: 943–950.

    Google Scholar 

  3. Australia-New Zealand Heart Failure Research Collaborative Group. Effects of carvedilol, a vasodilator-beta-blocker, in patients with congestive heart failure due to ischemic heart disease. Circulation 1995; 92: 212–218.

    Google Scholar 

  4. Short JH, Darby TD. Sympathetic nervous system blocking agents. III. Derivatives of benzylguanidine. J Med Chem 1967; 10: 833–840.

    Google Scholar 

  5. Wieland DM, Wu JI, Brown LE, Mangner TJ, Swanson DP, Beierwaltes WH. Radiolabeled adrenergic neuronbocking agents: Adrenomedullary imaging with [131I]-iodobenzylguanidine. J Nucl Med 1980; 21: 349–353.

    Google Scholar 

  6. Sisson JC, Frager MS, Valk TW, Gross MD, Swanson DP, Wieland DM, Tobes MC, Beierwaltes WH, Thompson NW. Scintigraphic localization of pheochromocytoma. N Engl J Med 1981; 305: 12–17.

    Google Scholar 

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

    Google Scholar 

  8. Tobes MC, Jaques S,Jr., Wieland DM, Sisson JC. Effect of uptake- one inhibitors on the uptake of norepinephrine and metaiodobenzylguanidine. J Nucl Med 1985; 26: 897–907.

    Google Scholar 

  9. Dae MW, De Marco T, Botvinick EH, O'Connell JW, Hattner RS, Huberty JP, Yuen Green MS. Scintigraphic assessment of MIBG uptake in globally denervated human and canine hearts-implications for clinical studies. J Nucl Med 1992; 33: 1444–1450.

    Google Scholar 

  10. Sisson JC, Bolgos G, Johnson J. Measuring acute changes in adrenergic nerve activity of the heart in the living animal. Am Heart J 1991; 121: 1119–1123.

    Google Scholar 

  11. Mangner TJ, Tobes MC, Wieland DW, Sisson JC, Shapiro B. Metabolism of iodine-131 metaiodobenzylguanidine in patients with metastatic pheochromocytoma. J Nucl Med 1986; 27: 37–44.

    Google Scholar 

  12. Mitrani RD, Klein LS, Miles WM, Hackett FK, Burt RW, Wellman HN, Zipes DP. Regional cardiac sympathetic denervation in patients with ventricular tachycardia in the absence of coronary artery disease. J Am Coll Cardiol 1993; 22: 1344–1353.

    Google Scholar 

  13. Shakespeare CF, Page CJ, O'Doherty MJ, Nunan TO, Cooper IC, Katritsis D, Coltart DJ. Regional sympathetic innervation of the heart by means of metaiodobenzylguanidine imaging in silent ischemia. Am Heart J 1993; 125: 1614–1622.

    Google Scholar 

  14. Merlet P, Valette H, Dubois Rande JL, Moyse D, Duboc D, Dove P, Bourguignon MH, Benvenuti C, Duval AM, Agostini D, Loisance D, Castaingne A, Syrota A. Prognostic value of cardiac metaiodobenzyl- guanidine imaging in patients with heart failure. J Nucl Med 1992; 33: 471–477.

    Google Scholar 

  15. Schofer J, Spielmann R, Schuchert A, Weber K, Schluter M. Iodine-123 meta-iodobenzylguanidine scintigraphy: a noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy. J Am Coll Cardiol 1988; 12: 1252–1258.

    Google Scholar 

  16. Tsuchimochi S, Tamaki 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 

  17. Estorch M, Carrio I, Berna L, Lopez-Pousa J, Torres G. Myocardial iodine-labeled metaiodobenzylguanidine 123 uptake relates to age. J Nucl Cardiol 1995; 2: 126–132.

    Google Scholar 

  18. Somsen GA, van Vlies B, Borm JJJ, de Milliano PAR, van Royen EA, Lie KI. Decreased cardiac sympathetic activity after 6 weeks treatment with enalapril in patients with congestive heart failure; a quantative MIBG-SPECT analysis. J Nucl Cardiol 1995; 2: S64/11–254 (Abstract).

    Google Scholar 

  19. Somsen GA, Borm JJJ, de Milliano PAR, van Vlies B, Dubois EA, van Royen EA. Quantitation of myocardial iodine-123-MIBG uptake in SPECT studies: a new approach using the left ventricular cavity and a blood sample as a reference. Eur J Nucl Med 1995; 22: 1149–1154.

    Google Scholar 

  20. Hasking GJ, Esler MD, Jennings GL, Burton D, Johns JA, Korner PI. Norepinephrine spillover to plasma in patients with congestive heart failure: Evidence of increased overall and cardiorenal sympathetic nervous activity. Circulation 1986; 73: 615–621.

    Google Scholar 

  21. Meredith IT, Eisenhofer G, Lambert GW, Dewar EM, Jennings GL, Esler MD. Cardiac sympathetic nervous activity in congestive heart failure: Evidence for increased neuronal norepinephrine release and preserved neuronal uptake. Circulation 1993; 88: 136–145.

    Google Scholar 

  22. Petch MC, Nayler WG. Uptake of catecholamines by human cardiac muscle in vitro. Br Heart J 1979; 41: 336–339.

    Google Scholar 

  23. Bohm M, La Rosee K, Schwinger RHG, Erdmann E. Evidence for reduction of norepinephrine uptake sites in the failing human heart. J Am Coll Cardiol 1995; 25: 146–153.

    Google Scholar 

  24. Glowniak JV, Turner FE, Gray LL, Palac RT, Lagunas Solar MC, Woodward WR. Iodine-123 metaiodobenzylguanidine imaging of the heart in idiopathic congestive cardiomyopathy and cardiac transplants. J Nucl Med 1989; 30: 1182–1191.

    Google Scholar 

  25. Henderson EB, Kahn JK, Corbett JR, Jansen DE, Pippin JJ, Kulkarni P, Ugolini V, Akers MS, Hansen C, Buja LM, et al. 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 

  26. Yamakado K, Takeda K, Kitano T, Nakagawa T, Futagami Y, Koishi T, Hamada M, Nakano T, Ichihara T. Serial change of iodine- 123 metaiodobenzylguanidine (MIBG) myocardial concentration in patients with dilated cardiomyopathy. Eur J Nucl Med 1992; 19: 265–270.

    Google Scholar 

  27. Dae MW, O'Connell JW, Botvinick EH, Ahearn T, Yee E, Huberty JP, Mori H, Chin MC, Hattner RS, Herre JM, et al. Scintigraphic assessment of regional cardiac adrenergic innervation. Circulation 1989; 79: 634–644.

    Google Scholar 

  28. Merlet P, Dubois Rande J, Adnot S, Bourguignon MH, Benvenuti C, Loisance D, Valette H, Castaigne A, Syrota A. Myocardial beta — adrenergic desensitization and neuronal norepinephrine uptake function in idiopathic dilated cardiomyopathy. J Cardiovasc Pharmacol 1992; 19: 10–16.

    Google Scholar 

  29. Goldstein DS, Brush JE, Eisenhofer G, Stull R, Esler MD. In vivo measurement of neuronal uptake of norepinephrine in the human heart. Circulation 1988; 78: 41–48.

    Google Scholar 

  30. Stanton MS, Tuli MM, Radtke NL, Heger JJ, Miles WM, Mock BH, Burt RW, Wellman HN, Zipes DP. Regional sympathetic denervation after myocardial infarction in humans detected noninvasively using I-123-metaiodobenzylguanidine. J Am Coll Cardiol 1989; 14: 1519–1526.

    Google Scholar 

  31. Dae MW, Herre JM, O'Connell JW, Botvinick EH, Newman D, Munoz L. Scintigraphic assessment of sympathetic innervation after transmural versus nontransmural myocardial infarction [see comments]. J Am Coll Cardiol 1991; 17: 1416–1423.

    Google Scholar 

  32. Hartikainen J, Kuikka J, Mantysaari M, Lansimies E, Pyorala K. Sympathetic reinnervation after acute myocardial infarction. Am J Cardiol 1996; 77: 5–9.

    Google Scholar 

  33. Merlet P, Pouillart F, Dubois-Randé JL, Castaigne A, Syrota A. Improved adrenergic nerve function in human failing heart after beta- blocking therapy. J Nucl Med 1994; 35: 81P (abstract).

    Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Academic Medical Centre, room B2-214, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    G. Aernout Somsen MD

  2. Department of Cardiology, University Hospital Leiden, The Netherlands

    Ernst E. van der Wall

  3. Department of Cardiology, Elisabeth Gasthuis Haarlem, The Netherlands

    Bob van Vlies

  4. Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, The Netherlands

    Judocus J. J. Borm & Eric A. van Royen

Authors
  1. G. Aernout Somsen MD
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  2. Ernst E. van der Wall
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  4. Judocus J. J. Borm
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  5. Eric A. van Royen
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Somsen, G.A., van der Wall, E.E., van Vlies, B. et al. Neuronal dysfunction in heart failure assessed by cardiac 123-iodine metaiodobenzylguanidine scintigraphy. Int J Cardiac Imag 12, 305–310 (1996). https://doi.org/10.1007/BF01797744

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