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Abnormal cardiac nerve function in syndrome X.

G A Lanza1

  • 1Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy.

Herz
|June 18, 1999
PubMed
Summary
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Cardiac sympathetic nerve dysfunction is prevalent in Syndrome X patients, indicated by abnormal MIBG uptake. This impairment likely contributes to the condition

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Neuroscience

Background:

  • Syndrome X, characterized by chest pain and normal coronary angiograms, is suspected to involve small coronary artery dysfunction.
  • Previous research on increased adrenergic activity in Syndrome X yielded conflicting results due to indirect investigation methods.

Purpose of the Study:

  • To directly investigate cardiac sympathetic nerve function in Syndrome X patients.
  • To assess the role of adrenergic activity in the pathogenesis of Syndrome X using myocardial radionuclide studies.

Main Methods:

  • Employed 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy in 12 Syndrome X patients and 10 healthy controls.
  • Quantified cardiac MIBG uptake using the heart/mediastinum (H/M) ratio and a semiquantitative MIBG uptake score.

Related Experiment Videos

  • Correlated MIBG findings with stress thallium scintigraphy results.

    • Main Results:

    • Significant abnormalities in cardiac MIBG uptake were observed in 75% of Syndrome X patients compared to 10% of controls (p < 0.01).
    • Syndrome X patients exhibited lower H/M ratios (1.70 vs. 2.19, p = 0.03) and higher MIBG uptake scores (36.7 vs. 4.0, p = 0.003).
    • Abnormal MIBG scintigrams in Syndrome X patients correlated with reversible perfusion defects on thallium scintigraphy.

    Conclusions:

    • Cardiac sympathetic nerve function, specifically efferent adrenergic nerve fibers, is significantly impaired in the majority of Syndrome X patients.
    • This impaired nerve function is a likely contributor to the pathophysiology and clinical presentation of Syndrome X.
    • Altered cardiac nerve function may also explain the increased cardiac pain perception in these patients.