| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
First Department of Internal Medicine and Division of Radiology, Yamagata University School of Medicine, Yamagata, Japan
Correspondence: For correspondence or reprints contact: Yasuchika Takeishi, MD, First Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-23 Japan.
ABSTRACT
Radioiodinated metaiodobenzylguanidine (123I-MIBG), an analog of norepinephrine, has been used to assess cardiac sympathetic nerve activity. Decreased myocardial accumulation and enhanced wash out of 123I-MIBG have been reported in patients with congestive heart failure (CHF). The purpose of this study was to determine whether angiotensin converting enzyme (ACE) inhibition reduced 123I-MIBG release and improved cardiac 123I-MIBG accumulation in patients with CHF. Methods: Twenty-nine patients receiving conventional treatment for CHF, New York Heart Association (NYHA) functional class 2–3,were studied.Nineteen patients received ad ditional treatment with enalapril,an ACE inhibitor,and 10 patients who were treated with conventional therapy alone were defined as a control group. Iodine-123-MIBG imaging and echocardiography were performed on all patients before treatment and repeated after 9.1 ± 3.0 mo of treatment. Images were obtained 30 min and 4 hr after injection of 123I-MIBG, and a heart to mediastinum (H/M) ratio was defined to quantify cardiac123I-MIBG uptake as a fraction of the mean counts per pixel in the heart divided by those in the mediastinum. The washout rate of 123I-MIBG from the heart was calculated as follows: (early counts - delayed counts)/early counts x 100 (%). Results: In patients with enalapril group, the H/M ratio of 123I-MIBG was increased after treatment (early image: 1.60 ± 0.22 vs. 1.73 ± 0.28,p < 0.05, delayed image: 1.63 ± 0.28 vs. 1.82 ± 0.33, p < 0.01). 1The washout rate of 123I-MIBG was reduced from 38% ± 11% to 30% ± 12% after treatment (p < 0.01).However in the conventional therapy group, the H/M ratios in the early and delayed images (early image: 1.58 ± 0.31 vs. 1.52 ± 0.23, delayed image: 1.49 ± 0.27 vs. 1.49 ± 0.25) and the washout rate (34% ± 8% vs. 33% ± 7%) remained unchanged after treatment. In patients with an increased H/M ratio of enalapril group (n = 13), a left ventricular ejection fraction increased from 48% ± 12% to 55% ± 9%(p < 0.01) after treatment. Conclusion: ACE inhibition reduces cardiac 123I-MIBG release and thus lowers cardiac sympathetic nerve activity. Iodine-123-MIBG may be helpful in evaluating the therapeutic effects of ACE inhibition on the cardiac sympathetic nervous system in patients with CHF.
Key Words: iodine-123-MIBG • heart failure • angiotensin-converting enzyme inhibitor
This article has been cited by other articles:
|
|
 |
|
  S. Kasama, T. Toyama, H. Sumino, M. Nakazawa, N. Matsumoto, Y. Sato, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, et al. Prognostic Value of Serial Cardiac 123I-MIBG Imaging in Patients with Stabilized Chronic Heart Failure and Reduced Left Ventricular Ejection Fraction J. Nucl. Med., June 1, 2008; 49(6): 907 - 914. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kasama, T. Toyama, H. Sumino, N. Matsumoto, Y. Sato, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Additive Effects of Spironolactone and Candesartan on Cardiac Sympathetic Nerve Activity and Left Ventricular Remodeling in Patients with Congestive Heart Failure J. Nucl. Med., December 1, 2007; 48(12): 1993 - 2000. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kasama, T. Toyama, H. Sumino, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Long-Term Nicorandil Therapy Improves Cardiac Sympathetic Nerve Activity After Reperfusion Therapy in Patients with First Acute Myocardial Infarction J. Nucl. Med., October 1, 2007; 48(10): 1676 - 1682. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kasama, T. Toyama, T. Hatori, H. Sumino, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Effects of Intravenous Atrial Natriuretic Peptide on Cardiac Sympathetic Nerve Activity and Left Ventricular Remodeling in Patients With First Anterior Acute Myocardial Infarction J. Am. Coll. Cardiol., February 13, 2007; 49(6): 667 - 674. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Kasama, T Toyama, T Hatori, H Sumino, H Kumakura, Y Takayama, S Ichikawa, T Suzuki, and M Kurabayashi Effects of torasemide on cardiac sympathetic nerve activity and left ventricular remodelling in patients with congestive heart failure Heart, October 1, 2006; 92(10): 1434 - 1440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kasama, T. Toyama, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Effects of candesartan on cardiac sympathetic nerve activity in patients with congestive heart failure and preserved left ventricular ejection fraction J. Am. Coll. Cardiol., March 1, 2005; 45(5): 661 - 667. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kasama, T. Toyama, H. Kumakura, Y. Takayama, T. Ishikawa, S. Ichikawa, T. Suzuki, and M. Kurabayashi Effects of Intravenous Atrial Natriuretic Peptide on Cardiac Sympathetic Nerve Activity in Patients with Decompensated Congestive Heart Failure J. Nucl. Med., July 1, 2004; 45(7): 1108 - 1113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kurata, A. Uehara, and A. Ishikawa Improvement of Cardiac Sympathetic Innervation by Renal Transplantation J. Nucl. Med., July 1, 2004; 45(7): 1114 - 1120. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Nakamura, K. Chin, R. Hosokawa, K. Takahashi, K. Sumi, M. Ohi, and M. Mishima Corrected QT Dispersion and Cardiac Sympathetic Function in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome Chest, June 1, 2004; 125(6): 2107 - 2114. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kyuma, T. Nakata, A. Hashimoto, K. Nagao, H. Sasao, T. Takahashi, K. Tsuchihashi, and K. Shimamoto Incremental Prognostic Implications of Brain Natriuretic Peptide, Cardiac Sympathetic Nerve Innervation, and Noncardiac Disorders in Patients with Heart Failure J. Nucl. Med., February 1, 2004; 45(2): 155 - 163. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Arao, N. Takabatake, M. Sata, S. Abe, Y. Shibata, T. Honma, K. Takahashi, A. Okada, Y. Takeishi, and I. Kubota In Vivo Evidence of Endothelial Injury in Chronic Obstructive Pulmonary Disease by Lung Scintigraphic Assessment of 123I-Metaiodobenzylguanidine J. Nucl. Med., November 1, 2003; 44(11): 1747 - 1754. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kasama, T. Toyama, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Addition of Valsartan to an Angiotensin-Converting Enzyme Inhibitor Improves Cardiac Sympathetic Nerve Activity and Left Ventricular Function in Patients with Congestive Heart Failure J. Nucl. Med., June 1, 2003; 44(6): 884 - 890. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Altmann, M. Kissel, S. Zitzmann, W. Kubler, M. Mahmut, P. Peschke, and U. Haberkorn Increased MIBG Uptake After Transfer of the Human Norepinephrine Transporter Gene in Rat Hepatoma J. Nucl. Med., June 1, 2003; 44(6): 973 - 980. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kasama, T. Toyama, H. Kumakura, Y. Takayama, S. Ichikawa, T. Suzuki, and M. Kurabayashi Effect of spironolactone on cardiacsympathetic nerve activity and left ventricular remodeling in patients with dilated cardiomyopathy J. Am. Coll. Cardiol., February 19, 2003; 41(4): 574 - 581. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Wakabayashi, T. Nakata, A. Hashimoto, S. Yuda, K. Tsuchihashi, M. I. Travin, and K. Shimamoto Assessment of Underlying Etiology and Cardiac Sympathetic Innervation to Identify Patients at High Risk of Cardiac Death J. Nucl. Med., December 1, 2001; 42(12): 1757 - 1767. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Kawai, T.-H. M. Fan, E. Dong, R. A. Siddiqui, A. Yatani, S. Y. Stevens, and C.-S. Liang ACE inhibition improves cardiac NE uptake and attenuates sympathetic nerve terminal abnormalities in heart failure Am J Physiol Heart Circ Physiol, October 1, 1999; 277(4): H1609 - H1617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Nazzaro, M. Manzari, M. Merlo, R. Triggiani, A. Scarano, L. Ciancio, and A. Pirrelli Distinct and Combined Vascular Effects of ACE Blockade and HMG-CoA Reductase Inhibition in Hypertensive Subjects Hypertension, February 1, 1999; 33(2): 719 - 725. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Sakata, M. Shirotani, H. Yoshida, and C. Kurata Comparison of effects of enalapril and nitrendipine on cardiac sympathetic nervous system in essential hypertension J. Am. Coll. Cardiol., August 1, 1998; 32(2): 438 - 443. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
