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Abnormal myocardial uptake and clearance of 123I-labeled metaiodobenzylguanidine in patients with chronic renal failure and autonomic dysfunction

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Patients with chronic renal failure were evaluated with 123I-labeled metaiodo-benzylguanidine (MIBG) myocardial scintigraphy to investigate the relationship between abnormal findings on MIBG scintigrams and autonomic dysfunction.

Methods and Results

Eleven control subjects and 20 patients with chronic renal failure (CRF) (serum creatinine level >8 mg/dl) were evaluated by MIBG myocardial scintigraphy and power spectral analysis (PSA) of the R-R fluctuations of the electrocardiogram. Subjects with CRF were divided into two groups: without (CRF1; nine patients) or with (CRF2; 11 patients) autonomic neuropathy. From MIBG images, the heart/mediastinum mean count rate, defect score, which was scored visually, and clearance rate were calculated. Percent low-frequency power and high-frequency power were obtained from PSA. MIBG scintigrams showed decreased heart/mediastinum mean count rate, a high defect score in both initial and delayed images, and rapid clearance rate in the CRF2 group. PSA showed an abnormally low percent low-frequency power and high-frequency power in the CRF2 group. In addition, there was a weak but significant inverse correlation between percent low-frequency power and defect score.

Conclusion

Alterations in MIBG scintigrams are seen in patients with autonomic dysfunction in CRF and may be useful for evaluating cardiac sympathetic dysfunction in those patients.

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References

  1. Wieland DM, Wu JI, Brown LE, Mangner TJ, Swanson DP. Radiolabeled adrenergic neuron blocking agents: adrenomedullary imaging with [131I] iodobenzylguanidine. J Nucl Med 1980;21: 349–53.

    PubMed  CAS  Google Scholar 

  2. Klin RC, Swanson DP, Wieland DM, Thrall JH, Gross MD, Pitt B, et al. Myocardial imaging in man with I-123 metaiodobenzylguanidine. J Nucl Med 1981;22:129–132.

    Google Scholar 

  3. Nishimura T, Uehara T, Oka H, Kumita S, Mitani I, Yokota I, et al. Serial assessment of denervated but viable myocardium following acute myocardial infarction by using 123I-MIBG and 201Tl myocardial SPECT. Jpn J Nucl Med 1990;27:709–718.

    CAS  Google Scholar 

  4. Satoh K, Katoh K, Muata H, et al. Assessment of ischemic damage of the cardiac sympathetic nerve function by semiquantitative analysis of 123I-MIBG (metaiodobenzylguanidine) SPECT: comparison with 201Tl-Cl-SPECT. Jap J Nucl Med 1990;27:821–31.

    CAS  Google Scholar 

  5. Nishimura T, Kurita T, Ohe T, Hayashida K, Uehara T, Mitani I, et al. A case of myocardial infarction with ventricular tachycardia which had discrepancy of defect size between 123I-MIBG and 201TlCl myocardial imaging. Jpn J Nucl Med 1989;26:419–423.

    CAS  Google Scholar 

  6. Henderson EB, Kahn JK, Corbett JR, Jansen DE, Pippin JJ, Kulkarni P, 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.

    PubMed  CAS  Google Scholar 

  7. Mantysaari M, Kukka J, Mustonen J, Tavanainenet K, Vanninen E, Lansimies E, et al. Noninvasive detection of cardiac sympathetic nervous dysfunction in diabetic patients using [123I] Metaiodobenzylguanidine. Diabetes 1992;41:1069–1075.

    Article  PubMed  CAS  Google Scholar 

  8. Nakajo M, Shimabukuro K, Miyaji N, Shimada J, Shirono K, Sakata H, et al. Rapid clearance of iodine-131-MIBG from the heart and liver of patients with adrenergic dysfunction and pheochromocytoma. J Nucl Med 1985;26:357–365.

    PubMed  CAS  Google Scholar 

  9. Ohtomo N, Terachi S, Tanaka Y. Nonlinear time series analysis, 1: a new method of analysis and theoretical background. Bull Fac Eng Hokkaido Univ 1991;158:43–55.

    Google Scholar 

  10. Tanaka Y, Ohtomo N, Terauchi S. Nonlinear time series analysis 6: on the MEM spectrum for cyclic function. Bull Fac Eng Hokkaido Univ 1993;163:47–52.

    Google Scholar 

  11. Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation. 1991;84:482–92.

    PubMed  CAS  Google Scholar 

  12. Hirahara Y, Nakamura C, Yamazaki T, Matsuda S, Fujita E, Mashima H, et al. Evaluation of autonomic functions in regular hemodialysis patients: Pathogenesis and management of orthostatic hypotension. J Hemodialysis 1991;24:1098–1104.

    Google Scholar 

  13. Kersh ES, Kronfield SJ, Unger A, Popper RW, Cantor S, Cohn K. Autonomic insufficiency in uremia as a cause of hemodialysis-induced hypotension. N Engl J Med 1974;290:650–3.

    PubMed  CAS  Google Scholar 

  14. Hennessy WJ, Siemsen AW. Autonomic neuropathy in chronic renal failure. Clin Res 1968;16:385.

    Google Scholar 

  15. Kimura M, Iseda K. Autonomic nerve dysfunction in chronic renal failure. Nihon Rinsyo Meneki Gakkai Kaishi 1992;50:830–5.

    Google Scholar 

  16. Ewing DJ, Winney R. Autonomic function in patients with chronic renal failure on intermittent hemodialysis. Nephron 1975;15: 424–9.

    Article  PubMed  CAS  Google Scholar 

  17. Lazarus JM, Hampers CL, Lowrie EG, Merrill JP. Baroreceptor activity in normotensive and hypertensive uremic patients. Circulation 1973;47:1015–21.

    PubMed  CAS  Google Scholar 

  18. Agarwal A, Anand IS, Sakhuja U, Chugh KS. Effect of dialysis and renal transplantation on autonomic dysfunction in chronic renal failure. Kidney Int 1991;40:489–95.

    Article  PubMed  CAS  Google Scholar 

  19. Pomeranz B, Macaulay RJB, Caudill MA, Kutz I, Adam D, Gordon D, et al. Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 1985;248:H151-H153.

    PubMed  CAS  Google Scholar 

  20. Pagani M, Lambardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli E, et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res 1986;59:178–193.

    PubMed  CAS  Google Scholar 

  21. Binkley PF, Nunziata E, Haas GJ, et al. Parasympathetic withdrawal is an integral component of autonomic regulation imbalance in congestive heart failure: demonstration in human subjects and verification in a paced canine model of ventricular failure. J Am Coll Cardiol 1991;18:464–72.

    Article  PubMed  CAS  Google Scholar 

  22. Ueda N. Detection of diabetic autonomic neuropathy: utilization of power spectral analysis of heart rate variability. J Jpn Diabetes Soc 1992;35:17–23.

    Google Scholar 

  23. Lin YE, Wang JY, Shum AY, Jiang HK, Lai WY, Lu KC, et al. Role of plasma catecholamines, autonomic and left ventricular function in normotensive and hypotension prone dialysis patients. ASAIO J 1993;39:946–953.

    Article  PubMed  CAS  Google Scholar 

  24. Carretta R, Fabris B, Fischetti F, Bardelli M, Muiesan S, Vran F, et al. Peripheral adrenoceptors in hypotension of hemodialyzed uremic patients. Nephron 1992;62:429–433.

    PubMed  CAS  Google Scholar 

  25. Daul AE, Wang XL, Michel MC, Brodde DE. Arterial hypertension in chronic hemodialyzed patients. Kidney Int 1987;32:728–35.

    Article  PubMed  CAS  Google Scholar 

  26. Tajiri M. A clinical study of persistent hypotension in patients on chronic hemodialysis. Nippon Jinzo Gakkai Shi 1993;35:223–31.

    PubMed  CAS  Google Scholar 

  27. Nakajo M, Shapiro B, Glowniak J, Sisson JC, Beierwaltes WH. Inverse relationship between cardiac accumulation of meta-I-131 iodobenzylguanizine (I-131 MIBG) and circulating catecholamines in suspected pheochromocytoma. J Nucl Med 1983;24: 1127–34.

    PubMed  CAS  Google Scholar 

  28. Hennemann H, Hevendeal G, Horier E, Heidland A. Toxic sympathicopathy in uremia. Proc Eur Dial Transplant Nephrol 1973; 9:166–9.

    Google Scholar 

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Authors and Affiliations

  1. Third Department of Internal Medicine, Matushita Memorial Hospital, Sotoshima-cyo 5-55, Moriguchi City, Osaka, Japan

    Hajime Miyanaga, Satoshi Yoneyama, Tadaaki Kamitani, Shingo Kawasaki, Toru Takahashi & Hiroshi Kunishige

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  1. Hajime Miyanaga
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  2. Satoshi Yoneyama
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  3. Tadaaki Kamitani
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  4. Shingo Kawasaki
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  5. Toru Takahashi
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  6. Hiroshi Kunishige
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Miyanaga, H., Yoneyama, S., Kamitani, T. et al. Abnormal myocardial uptake and clearance of 123I-labeled metaiodobenzylguanidine in patients with chronic renal failure and autonomic dysfunction. J Nucl Cardiol 3, 508–515 (1996). https://doi.org/10.1016/S1071-3581(96)90060-4

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  • DOI: https://doi.org/10.1016/S1071-3581(96)90060-4

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