Abstract
Background
123I-labeled metaiodobenzylguanidine (123I-MIBG) is used increasingly to assess cardiac adrenergic neuron function. Few studies have reported data on myocardial MIBG uptake in relation to age, with contradictory results. This study reports the results of myocardial MIBG studies in untreated patients with cancer to assess the influence of age on myocardial MIBG uptake.
Methods and Results
Thirty-nine patients with cancer enrolled in a study to assess the effect of doxorubicin administration on adrenergic neuron function underwent baseline studies with 123I-MIBG before chemotherapy. None of the patients had a history of neuropathy, previous cardiac disease, or previous chemotherapy or mediastinal radiotherapy. Myocardial MIBG uptake was quantified by a heart/mediastinal ratio (HMR) 4 hours after intravenous administration of 5 mCi, 123I-MIBG. The mean age of patients was 38 years, ranging from 16 to 75 years. Ten patients were below 20 years, 13 patients were between 20 and 40 years, six patients were between 40 and 60 years, and 10 patients were greater than 60 years of age. Myocardial 123I-MIBG uptake was observed in all patients, with a mean HMR of 1.85±0.29 (range 1.31 to 2.62). HMR correlated with age (r=−0.6264; p<0.001). A decrease in 123I-MIBG uptake with aging was observed. The mean HMR of patients of less than 20 years was 2.07, of patients between 20 and 40 years 1.89, of patients between 40 and 60 years 1.83, and of patients greater than 60 years 1.56. The best separation was observed comparing patients who were greater than 60 years (mean HMR 1.56 ± 0.16; range 1.31 to 1.78) with patients who were less than 60 years of age (mean HMR 1.95 ±0.;24; range 1.56 to 2.62; p=0.003).
Conclusions
Myocardial 123I-MIBG uptake relates to age. A decrease in myocardial MIBG uptake is observed with aging, especially in those patients over 60 years of age. The influence of age on myocardial MIBG uptake has to be taken into account when studies are designed to assess cardiac adrenergic neuron function with 123I-MIBG.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sisson JC, Wielan DM, Sherman P, et al. Meta-iodobenzylguanidine as an index of the adrenergic nervous system integrity and function. J Nucl Med 1987;28:1620–4.
Sisson JC, Shapiro B, Meyers L, et al. Meta-iodobenzylguanidine to map scintigraphically the adrenergic nervous system in man. J Nucl Med 1987;28:1625–36.
Wieland DM, Wu JL, Brown LE, Mangner TJ, Swanson DP, Beierwaltes WH. Radiolabeled adrenergic neuron-blocking agents: adrenomedullary imaging with (I-125)iodobenzylguanidine. J Nucl Med 1980;21:349–53.
Manger WM, Hoffman BB. Heart imaging in the diagnosis of pheochromocytoma and assessment of catecholamine uptake. J Nucl Med 1983;24:1194–6.
Wieland DM, Brown LE, Rogers WL, et al. Myocardial imaging with a radioiodinated norepinephrine storage analog. J Nucl Med 1981;22:22–31.
Iversen LL. Role of trnasmitter uptake mechanisms in synaptic neurotransmission. Br J Pharmacol 1971;41:571–91.
Lightman SL, Iversen LL. The role of uptake in the extraneuronal metabolism of catecholamines in the isolated rat heart. Br J Pharmacol 1969;37:638–49.
Nakajo M, Shimabukuro K, Yoshimura H, et al. Iodine-131 metaiodobenzylguanidine intra- and extravesicular accumulation in the rat heart. J Nucl Med 1986;27:84–9.
Dae MW, De Marco T, Botvinick EH, et al. Scintigraphic assessment of MIBG uptake in globally denervated human and canine hearts: implications for clinical studies. J Nucl Med 1992;33:1444–50.
Wakasugi S, Fischman AJ, Babich JW, et al. Metaiodobenzylguanidine: evaluation of its potential as a tracer for monitoring doxorubicin cardiomyopathy. J Nucl Med 1993;34:1282–6.
Fagret D, Wolf J, Vanzetto G, Borrel E. Myocardial uptake of metaiodobenzylguanidine in patients with left ventricular hypertrophy secondary to valvular aortic stenosis. J Nucl Med 1993;34:57–60.
Gill JS, Hunter GJ, Gane G, Camm, AJ. Heterogeneity of the human myocardial sympathetic innervation: in vivo demonstration by iodine-labeled meta-iodobenzylguanidine scintigraphy. Am Heart J 1993;126:390–8.
Tsuchimochi S, Tamaki N, Shirakawa S, et al. Evaluation of myocardial distribution of iodine-123 labeled metaiodoben.-zylguanidine (123I-MIBG) in normal subjects. Jpn J Nucl Med 1994;3:257–64.
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;12:1252–8.
Carrió I, Serra-Grima R, Berná LI, et al. Transient alterations in cardiac performance after a six-hour race. Am J Cardiol 1990;65:1471–4.
Nakajo M, Shapiro B, Glowniak J, Sisson JC, Beierwaltes WH. Inverse relationship between cardiac accumulation of meta (131I)iodobenzylguanidine and circulating catecholamines in suspected pheochromocytoma. J Nucl Med 1983;24:1127–34.
Fagret D, Wolf J, Comet M. Myocardial uptake of meta-(123I)iodobenzylguanidine (123I-MIBG) in patients with myocardial infarct. Eur J Nucl Med 1989;15:624–8.
Henderson EB, Kahn JK, Corbett JR, et al. Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy. Circulation 1988;78:1192–9.
Chidsey CA, Braunwald E, Morrow AG. Catecholamine excretion and cardiac stores of norepinephrine in congestive heart failure. Am J Med 1965;39:442–51.
Glowniak JV, Turner FE, Gray LL, et al. Iodine-123 metaiodobenzylguanidine imaging of the heart in idiopathic congestive cardiomyopathy and cardiac transplants. J Nucl Med 1989;30:1182–91.
Yamakado K, Takeda K, Kitano T, et al. Serial change of iodine-123 metaiodobenylguanidine (MIBG) myocardial concentration in patients with dilated cardiomyopathy. Eur J Nucl Med 1992;19:265–70.
Amorim DS, Olsen EGJ. Assessment of heart neurons in dilated (congestive) cardiomyopathy. Br Heart J 1982;47:11–8.
Sole MJ, Lo CM, Laird CW, Sonnenblick EH, Wurtman RJ. Norepinephrine turnover in the heart and spleen of the cardiomyopathic syrian hamster. Circ Res 1975;37:855–62.
Schömig A, Fischer S, Kurz T, Richardt G, Schömig E. Nonexocytotic release of endogenous noradrenaline in the ischemic and anoxic rat heart: mechanism and metabolic requirements. Circ Res 1987;60:194–205.
Wakasugi S, Wada A, Hasegawa Y, Nakano S, Shibata N. Detection of abnormal cardiac adrenergic neuron activity in Adriamycin-induced cardiomyopathy with iodine-125-meta-iodobenzylguanidine. J Nucl Med 1992;33:208–14.
Nakajo M, Shapiro B, Copp, J, et al. The normal and abnormal distribution of the adrenomedullary imaging agent I-131 MIBG in men. J Nucl Med 1983;24:672–82.
Bonow RO, Vitale DF, Bacharach SL, Maron BJ, Green MV. Effects of aging on asynchronous left ventricular regional function and global ventricular filling in normal human subjects. J Am Coll Cardiol 1988;11:50–8.
Lakatta EG. Changes in cardiovascular function with aging. Eur Heart J 1992;11:22–9.
Serra-Grima R, Carrió I, Estorch M, et al. ECG alterations in the athlete type “pseudoischemia”. J Sports Cardiol 1986;3:9–16.
Kitzman DW. Age related changes in normal human hearts during the first 10 decades of life, part II (maturity): a quantitative anatomic study of 765 specimens from subjects 20 to 99 years old. Mayo Clin Proc 1988;63:137–46.
Author information
Authors and Affiliations
Additional information
Supported by grant DGICYT PB93-1016.
Rights and permissions
About this article
Cite this article
Estorch, M., Carrió, I., Berná, L. et al. Myocardial iodine-labeled metaiodobenzylguanidine 123 uptake relates to age. J Nucl Cardiol 2, 126–132 (1995). https://doi.org/10.1016/S1071-3581(95)80023-9
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1016/S1071-3581(95)80023-9