Correlation Between Cardiac Norepinephrine Overflow During Exercise and Cardiac 123I-MIBG Uptake in Patients with Chronic Heart Failure

Journal of Nuclear Medicine

Takako Ishihata¹  Masahiko Sato¹  Akira Hirosaka¹  Kazuhira Maehara¹  Nobuo Komatsu¹  Yukio Maruyama¹  Hiroshi Otani¹  Hiroyuki Yaoita¹  Norio Onuki¹  Tomiyoshi Saito¹ 

[1] First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan

关键词: chronic heart failure;    cardiac sympathetic nerve;    ¹²³I-MIBG;    norepinephrine;    dynamic exercise;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Cardiac 123I-metaiodobenzylguanidine (123I-MIBG) uptake is reduced in chronic heart failure, and its reduction is reported to relate to the decrease in exercise capacity. Reduced 123I-MIBG uptake may predict an inadequately reduced adrenergic drive to the heart during cardiac sympathetic stimulation, including exercise. However, there is little information about the relationship between cardiac 123I-MIBG uptake at rest and norepinephrine (NE) release during exercise in relation to the exercise capacity in the failing heart. The aim of this study was to examine whether cardiac 123I-MIBG uptake at rest can predict cardiac sympathetic activity during exercise in patients with chronic heart failure. We determined how cardiac 123I-MIBG uptake at rest relates to NE overflow from the heart during symptom-limited graded exercise in such patients. Methods: Twelve patients (mean ± SD, 52 ± 12 y) with chronic stable heart failure performed symptom-limited graded exercise tests under catheterizations with a 4-min stage using a supine bicycle ergometer within 2 wk after 123I-MIBG imaging. NE concentrations in the arterial and coronary sinus blood (NEA and NECS, respectively) were measured at each exercise stage, and NE overflow was approximated by the difference between NECS and NEA (NECS−A). Results: The left ventricular ejection fraction at rest was 47% ± 16% and peak oxygen uptake was 17.7 ± 5.1 mL/kg/min. The heart-to-mediastinum uptake ratio of the delayed 123I-MIBG image (1.00∼1.72; mean ± SD, 1.30 ± 0.19) correlated with NECS−A at peak exercise (r = 0.80, P < 0.01) and peak heart rate (r = 0.73, P < 0.01) but not with peak oxygen uptake. Conclusion: Cardiac 123I-MIBG uptake of the delayed image can predict the degree of the increase in adrenergic drive to the heart during sympathetic stimuli induced by exercise in patients with chronic heart failure.

【 授权许可】

Unknown