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Cardiac 123I-MIBG reflects left ventricular functional reserve in patients with nonobstructive hypertrophic

Satoshi Isobe1, Hideo Izawa, Mitsunori Iwase

  • 1Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. sisobe@med.nagoya-u.ac.jp

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|June 7, 2005
PubMed

Insights

Cardiac sympathetic nerve function assessed by myocardial iodine-123-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy correlates with left ventricular (LV) functional reserve during exercise in hypertrophic cardiomyopathy (HCM) patients.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Cardiovascular Physiology

Background:

  • Left ventricular (LV) functional reserve during exercise is crucial in hypertrophic cardiomyopathy (HCM).
  • Cardiac sympathetic nervous function's role in HCM exercise response is not well understood.
  • Myocardial iodine-123-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy assesses sympathetic innervation.

Purpose of the Study:

  • To investigate the relationship between cardiac sympathetic nervous function and LV functional reserve during exercise in nonobstructive HCM patients.
  • To determine if (123)I-MIBG scintigraphy can predict abnormal LV functional reserve in response to exercise-induced beta-adrenergic stimulation.

Main Methods:

  • Thirty HCM patients underwent (123)I-MIBG scintigraphy and echocardiography at rest.
  • Biventricular cardiac catheterization was performed at rest and during dynamic exercise to measure LV pressures.
  • Plasma levels of brain natriuretic peptide (BNP) and norepinephrine (NE) were measured.

Main Results:

  • Patients were grouped by delayed (123)I-MIBG heart-to-mediastinum ratio (H/M).
  • Group I (H/M ≤ 1.8) showed significantly less increase in LV dP/dt(max) and T(1/2) shortening during exercise compared to Group II (H/M > 1.8).
  • Significant correlations were found between LV functional reserve indices and (123)I-MIBG H/Ms; plasma NE levels were higher in Group I.

Conclusions:

  • Beta-adrenergic enhancement of LV function during exercise in HCM patients depends on cardiac sympathetic innervation.
  • (123)I-MIBG scintigraphy is a valuable noninvasive tool for evaluating LV functional reserve in response to exercise in nonobstructive HCM.
Abstract

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