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Cardiac autonomic dysfunction in Brugada syndrome
Thomas Wichter1, Peter Matheja, Lars Eckardt
1Hospital of the Westfälische Wilhelms-University, Department of Cardiology and Angiology, Münster, Germany. wichtet@uni-muenster.de
Circulation
|February 13, 2002
Summary
Brugada syndrome patients show abnormal cardiac norepinephrine reuptake, suggesting presynaptic sympathetic nerve dysfunction. This finding may impact understanding of Brugada syndrome pathophysiology and arrhythmia development.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Molecular Imaging
Background:
- Brugada syndrome is characterized by ECG abnormalities and life-threatening arrhythmias in structurally normal hearts.
- Autonomic nervous system involvement is suggested by arrhythmias occurring at rest and altered ECG signs with autonomic modulation.
Purpose of the Study:
- To investigate presynaptic cardiac neuronal norepinephrine reuptake (uptake 1) in Brugada syndrome patients.
- To compare norepinephrine reuptake between Brugada syndrome patients and healthy controls using advanced imaging techniques.
Main Methods:
- Utilized [123I]m-iodobenzylguanidine (123I-MIBG) for imaging presynaptic cardiac sympathetic nerve function.
- Employed single-photon emission CT (SPECT) and quantitative 33-segment bull's-eye analysis.
- Studied 17 Brugada syndrome patients and 10 age-matched controls.
Main Results:
- Regionally reduced 123I-MIBG uptake was observed in 47% of Brugada syndrome patients, but none of the controls.
- Quantitative analysis revealed segmental reduction in the inferior and septal left ventricular walls in Brugada syndrome patients.
- No correlation was found between 123I-MIBG-SPECT findings and patient clinical characteristics.
Conclusions:
- Demonstrated abnormal 123I-MIBG uptake in Brugada syndrome, indicating cardiac presynaptic sympathetic dysfunction.
- Findings suggest a potential role for sympathetic dysfunction in Brugada syndrome pathophysiology and arrhythmogenesis.
- Further research is needed to explore sympathetic and parasympathetic nervous system balance in Brugada syndrome.
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