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MIBG Scintigraphic Assessment of Cardiac Adrenergic Activity in Response to Altitude Hypoxia

Association pour la Recherche en Physiologie de l'Environnement
Unité INSERM U 138, Faculté de Médecine, Créteil
Service Hospitalier Frédéric Joliot, CEA, Orsay
Service de Cardiologie, CHU Mondor, Créteil, France

Correspondence: For reprints contact: J. P. Richalet, Unité INSERM U 2, Faculté de Médecine, 8 rue du Général Sarrail, 94010 Créteil Cédex, France.

ABSTRACT

High altitude hypoxia induces a decrease in the cardiac chronotropic function at maximal exercise or in response to isoproterenol infusion, suggesting an alteration in the cardiac sympathetic activation. Iodine-123 metaiodobenzylguanidine ([¹²³I]MIBG) was used to map scintigraphically the cardiac sympathetic neuronal function in six male subjects (aged 32 ± 7 yr) after an exposure to high altitude that created hypoxic conditions. Results obtained just after return to sea level (RSL) were compared with the normal values obtained after 2 or 3 mo of normoxia (N). A static image was created as the sum of the 16-EKG gated images recorded for 10 min in the anterior view of the chest at 20, 60, 120, and 240 min after injection. Regions of interest were located over the heart (H), lungs (L), and mediastinum (M) regions. There was a significant decrease in the H/M and the L/M ratios in RSL compared to N condition. Plasma norepinephrine concentration was elevated during the stay at altitude but not significantly different in RSL compared to N. In conclusion, cardiac [¹²³I] MIBG uptake is reduced after an exposure to altitude hypoxia, supporting the hypothesis of an hypoxia-induced reduction of adrenergic neurotransmitter reserve in the myocardium. Furthermore, the observed significant decrease in pulmonary MIBG uptake suggests an alteration of endothelial cell function after exposure to chronic hypoxia.

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