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Sympathetic Reinnervation Demonstrated on Serial Iodine-123-Metaiodobenzylguanidine SPECT Images After Cardiac Transplantation

Departments of Radiology, Internal Medicine, Surgery and Pediatrics, National Cardiovascular Center, Osaka, Japan

Correspondence: For correspondence or reprints contact: Yoshio Ishida, MD, Department of Radiology, National Cardiovascular Center, 5 Fujishirodai, Suita, Osaka 565 Japan.

ABSTRACT

The transplanted heart is without autonomie nervous control in the early postsurgical period.We present here a case of cardiac transplantation in which ¹²³I-metaiodobenzylguanidine (MIBG) SPECT and an exercise-loading test were used to monitor the sympathetic reinnervation. The distribution of myocardial ¹²³I-MIBG uptake extended with time from 1 to 2 yr after surgery. However, functional improvement, estimated by the heart rate response to exercise,was not discernable during this period. The findings in this case suggest the feasibility of ¹²³I-MIBG SPECT imaging in the serial monitoring of sympathetic reinnervation after transplantation and that scintigraphic evidence of reinnervation precedes functional recovery.

Key Words: iodine-123-metaiodobenzylguanidine • cardiac transplantation • sympathetic reinnervation

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