Decreased Myocardial β-Adrenergic Receptor Density in Relation to Increased Sympathetic Tone in Patients with Nonischemic Cardiomyopathy

Journal of Nuclear Medicine

Masanao Naya¹  Yuji Kuge¹  Koichi Morita¹  Nagara Tamaki¹  Chietsugu Katoh¹  Masayuki Inubushi¹  Hiroshi Okamoto¹  Takahiro Tsukamoto¹  Kenichi Nishijima¹  Hiroyuki Tsutsui¹ 

关键词: β-adrenergic receptor;    heart failure;    sympathetic tone;    norepinephrine;   

DOI  :  10.2967/jnumed.107.043794

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Cardiac sympathetic function plays an important role in the regulation of left ventricular (LV) function and the pathophysiology of LV dysfunction. 11C-CGP-12177 (11C-CGP) has been used to assess myocardial β-adrenergic receptor (β-AR) density in vivo using PET. The aim of this study is to measure myocardial β-AR density in patients with nonischemic cardiomyopathy and to compare the measurements with various standard parameters of heart failure (HF), particularly with presynaptic function assessed by 123I- metaiodobenzylguanidine (123I-MIBG) imaging. Methods: 11C-CGP PET was performed on 16 patients with nonischemic cardiomyopathy and 8 age-matched healthy volunteers using a double injection method. A 11C-CGP dynamic scan for 75 min was performed after the injection of 11C-CGP with a high specific activity. After 30 min, 11C-CGP with a low specific activity was injected. The β-AR density of the whole LV was calculated on the basis of the graphical analysis method. Additionally, β-AR density was compared with LV ejection fraction (LVEF), sympathetic presynaptic function assessed using 123I-MIBG kinetics, and neurohormonal parameters. Results: The β-AR density of patients was significantly lower than that of healthy volunteers (3.80 ± 0.96 vs. 7.70 ± 1.92 pmol/mL; P < 0.0001). In the patients, β-AR density correlated significantly with LVEF (r = 0.62, P < 0.05). Furthermore, β-AR density correlated significantly with the 123I-MIBG washout rate (r = −0.68, P < 0.01) and delayed heart-to-mediastinum ratio (H/M ratio) (r = 0.61, P < 0.05). On the other hand, the correlation between β-AR density and early H/M ratio was not significant (r = 0.40, P = 0.13). The β-AR density of patients with severe HF (New York Heart Association functional [NYHA] class III) was significantly lower than that of those with NYHA functional class I or class II HF (3.24 ± 0.96 vs. 4.24 ± 0.73 pmol/mL; P < 0.05). Conclusion: A reduction in β-AR density measured by 11C-CGP PET was observed in patients with nonischemic cardiomyopathy. This downregulation may be due to the increased presynaptic sympathetic tone as assessed by 123I-MIBG imaging.

【 授权许可】

Unknown