Improvement of Cardiac Sympathetic Innervation by Renal Transplantation

Journal of Nuclear Medicine

Akira Ishikawa¹  Chinori Kurata¹  Akihiko Uehara¹ 

关键词: kidney transplantation;    metaiodobenzylguanidine;    heart rate variability;    sympathetic nervous system;    autonomic nervous system;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Chronic renal failure (CRF) patients on dialysis frequently show reduced heart rate variability (HRV), which has been reported to be corrected by renal transplantation. Recently, 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy has been used to evaluate cardiac sympathetic innervation, and uremic patients often show marked abnormalities of cardiac 123I-MIBG uptake. We investigated whether renal transplantation can improve cardiac 123I-MIBG uptake in patients with CRF on dialysis. Methods: We analyzed time- and frequency-domain measures of 24-h HRV and cardiac 123I-MIBG scintigraphy before and 1–3 mo after renal transplantation in 13 CRF patients on dialysis and in 10 control subjects. Results: Both 24-h HRV and cardiac 123I-MIBG uptake were significantly abnormal in the patients before transplantation compared with the control subjects. After transplantation, 123I-MIBG washout rate from the myocardium significantly decreased from 46% ± 21% to 20% ± 22% (P = 0.006), and the heart-to-mediastinum ratio of 123I-MIBG uptake in the late image significantly increased from 1.74 ± 0.39 to 2.06 ± 0.39 (P = 0.006). On the other hand, HRV measures tended to increase after transplantation but the changes did not reach statistical significance (P > 0.05). Conclusion: Renal transplantation provides the improvement of uremic cardiac sympathetic neuropathy assessed by 123I-MIBG imaging, which may be a more sensitive or at least an earlier marker than HRV.

【 授权许可】

Unknown