HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Terai, H. Articles by Mabuchi, H. Search for Related Content PubMed PubMed Citation Articles by Terai, H. Articles by Mabuchi, H.

Changes in Cardiac Sympathetic Nerve Innervation and Activity in Pathophysiologic Transition from Typical to End-Stage Hypertrophic Cardiomyopathy

¹ Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Kanazawa University, Kanazawa, Japan
² Biotracer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan

Left ventricular (LV) systolic function in hypertrophic cardiomyopathy (HCM) is usually normal. Late in the disease, however, LV systolic dysfunction and dilatation are recognized. Although abnormalities in cardiac sympathetic nerve activity in patients with HCM have been demonstrated using ¹²³I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy, the changes of cardiac sympathetic nerve activity throughout the clinical course from typical to end-stage HCM are unclear. The objective of this study was to evaluate the relationship between abnormalities on ¹²³I-MIBG myocardial scintigraphy and pathophysiologic changes in patients with HCM. Methods: We performed ¹²³I-MIBG scintigraphy on 46 patients with HCM and 18 age-matched control subjects. The patients were categorized into 3 groups: 28 patients with normal LV systolic function (group A), 9 patients with LV systolic dysfunction (group B), and 9 patients with LV systolic dysfunction and dilatation (group C). With planar ¹²³I-MIBG imaging, the heart-to-mediastinum ratio for early and delayed acquisitions and the washout rate were calculated. With SPECT, polar maps of the LV myocardium were divided into 20 segments. The regional uptake and washout rate were calculated from semiquantitative 20-segment bull’s-eye analysis. Results: The early uptake was significantly lower in group C than in the control group (P < 0.01). The washout rate was progressively higher in group A, group B, and group C (P < 0.01). Reduced regional early uptake was found in 2.9 ± 3.4 (group A), 4.1 ± 4.7 (group B), and 7.4 ± 4.3 (group C) segments, respectively. In group C, regional early uptake was significantly reduced, predominantly in the interventricular septal wall, and regional washout rate was increased in the apex and lateral wall. Conclusion: These results suggest that cardiac sympathetic nerve abnormalities in patients with HCM may advance with development of LV systolic dysfunction and dilatation and that ¹²³I-MIBG myocardial scintigraphy may be a useful tool for the evaluation of pathophysiologic changes in HCM.

Key Words: hypertrophic cardiomyopathy • ¹²³I-metaiodobenzylguanidine • sympathetic nerve activity • pathophysiologic changes

This article has been cited by other articles:

				S. F. Nagueh and J. J. Mahmarian Noninvasive Cardiac Imaging in Patients With Hypertrophic Cardiomyopathy J. Am. Coll. Cardiol., December 19, 2006; 48(12): 2410 - 2422. [Abstract] [Full Text] [PDF]

				S. R. Ommen There Is Much More to the Recipe Than Just Outflow Obstruction J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1551 - 1552. [Full Text] [PDF]