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Cardiac sympathetic dysfunction in left ventricular hypertrophy caused by arterial hypertension and degenerative

Riccardo Liga1, Alessia Gimelli2, Marco De Carlo3

  • 1Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy. riccardo.liga@gmail.com.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|July 3, 2020
PubMed

Insights

Cardiac sympathetic innervation is impaired in patients with left ventricular hypertrophy (LVH), with or without aortic stenosis (AS). The transcatheter aortic valve implantation (TAVI) procedure did not significantly impact cardiac sympathetic function.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Cardiovascular Imaging

Background:

  • Hypertension and aortic stenosis (AS) can lead to left ventricular hypertrophy (LVH).
  • Cardiac sympathetic dysfunction is implicated in cardiovascular disease progression.
  • Assessing cardiac sympathetic innervation is crucial in patients with LVH and AS.

Purpose of the Study:

  • To evaluate cardiac sympathetic innervation in patients with LVH and AS undergoing transcatheter aortic valve implantation (TAVI).
  • To compare sympathetic innervation in patients with LVH and AS, essential hypertension (HT), and controls.
  • To assess the impact of TAVI on cardiac sympathetic innervation.

Main Methods:

  • Utilized 123I-metaiodobenzylguanidine (MIBG) and 99mTc-tetrofosmin SPECT imaging.
  • Assessed sympathetic innervation and left ventricular (LV) perfusion.
  • Calculated innervation/perfusion mismatch score as an indicator of cardiac sympathetic dysfunction.

Main Results:

  • Patients with AS and LVH, and those with essential HT and LVH, showed higher innervation/perfusion mismatch scores than controls.
  • Significant LVH was identified as the primary predictor of impaired LV sympathetic innervation.
  • No significant changes in LV sympathetic innervation were observed 6 months post-TAVI, despite a marginal reduction in LV mass.

Conclusions:

  • Cardiac sympathetic innervation is demonstrably impaired in patients with LVH, irrespective of AS.
  • The TAVI procedure does not significantly alter cardiac sympathetic innervation in this patient cohort.
  • LVH is a key factor influencing cardiac sympathetic dysfunction.
Abstract

Keywords:
123I-metaiodobenzylguanidineCardiac sympathetic innervationaortic valvular stenosisinnervation/perfusion mismatchleft ventricular hypertrophy

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