The neuronal imaging in cardiology: 123I-mIBG in clinical practice

Neuronal imaging, or assessment of sympathetic activity of the heart, along with the study of perfusion, myocardial and coronary blood flow reserve, and contractility, is another unique facet of nuclear medicine and an integral component in unravelling and understanding the mechanisms of cardiovascular disease (CVD) development, predicting the course of the disease, preventing its complications, and choosing therapeutic tactics. Currently, nuclear cardiology methods are the only non-invasive ways of lifetime visualization of cardiac neurotransmission at the molecular level and assessment of functional integrity of sympathetic innervation circuit of the heart, violations of which may be the root cause of various CVDs. The article presents data of the literature devoted to the assessment of cardiac neuronal function in some CVDs using planar scintigraphy and single-photon emission computed tomography (SPECT) with ¹²³I-mIBG (123I-metaiodbenzylguanidine), a structural analogue of noradrenaline, which has been used in clinical practice for 45 years.