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Changes in cardiac sympathetic nerve innervation and activity in pathophysiologic transition from typical to

Hidenobu Terai1, Masami Shimizu, Hidekazu Ino

  • 1Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Kanazawa University, Kanazawa, Japan. yonken1@med.kanazawa-u.ac.jp

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|October 8, 2003
PubMed

Insights

Cardiac sympathetic nerve activity in hypertrophic cardiomyopathy (HCM) worsens with disease progression. Iodine-123 metaiodobenzylguanidine (MIBG) scintigraphy effectively evaluates these pathophysiologic changes in HCM patients.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Biomedical Imaging

Background:

  • Left ventricular (LV) systolic function in hypertrophic cardiomyopathy (HCM) is typically normal but can decline late in the disease.
  • Cardiac sympathetic nerve activity abnormalities in HCM are known but their progression is unclear.
  • Iodine-123 metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy assesses cardiac sympathetic nerve function.

Purpose of the Study:

  • To evaluate the relationship between 123I-MIBG scintigraphy findings and pathophysiologic changes in HCM.
  • To understand the progression of cardiac sympathetic nerve activity throughout the clinical course of HCM.

Main Methods:

  • 46 HCM patients and 18 controls underwent 123I-MIBG scintigraphy.
  • Patients were grouped by LV systolic function: normal (A), dysfunction (B), and dysfunction with dilatation (C).
  • Planar and SPECT imaging assessed early uptake, washout rate, and regional myocardial activity.

Main Results:

  • Group C (dysfunction with dilatation) showed significantly lower early 123I-MIBG uptake compared to controls.
  • Washout rates progressively increased from group A to C, indicating worsening sympathetic dysfunction.
  • Reduced regional uptake was most pronounced in group C, particularly in the interventricular septum.

Conclusions:

  • Cardiac sympathetic nerve abnormalities in HCM advance with LV systolic dysfunction and dilatation.
  • 123I-MIBG myocardial scintigraphy is a valuable tool for assessing pathophysiologic changes in HCM.
  • The findings support using 123I-MIBG to monitor disease progression in HCM.
Abstract

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