Evidence for Pre- to Postsynaptic Mismatch of the Cardiac Sympathetic Nervous System in Ischemic Congestive Heart Failure

Decay-corrected ¹¹C-mHED time–activity curves from myocardial and metabolite left atrial cavity (LA Cav) ROIs in CHF patient with our model fit to myocardial time–activity curves. (Left) Location of ROI 8 (arrowhead), a visually “normal” region, and the corresponding myocardial time–activity curve. (Right) Location of ROI 3, an abnormal mHED accumulation, is shown. ROIs are bounded by inside and outside arcs within each of 8 radial lines. Parameter estimates are given for PS_nt, PS_ves (¹¹C-mHED release by vesicles), V′_nt (virtual volume of nerve terminal), and G_seq (rate vesicular storage of mHED). MBF and the retention fraction (RF) of ¹¹C-mHED for the 2 ROIs are also shown.

Box-and-whisker plots for global values for MBF (left) and B′_max (right) for healthy subjects (normal) and CHF patients. Box represents 25%–75% of data; whiskers represent 5%–95%; heavy and thin solid lines are mean and median values, respectively.

Short-axis PET images of ¹¹C-mHED (35- to 45-min sum) and ¹¹C-CGP (10- to 20-min sum from injection 1) in CHF patient. Apical slices are at upper left and basal slices are at lower right of each panel. Arrows indicate extensive mismatch between ¹¹C-mHED and ¹¹C-CGP.

Box-and-whisker plots for regional NE transport (PS_nt) for 12 LV regions per subject. Locations of apical, middle, and basal slices lie between the white vertical bars on the long-axis image at upper left. Locations of large sectors—anterior, lateral, inferior, septal—are shown on short-axis image. Normals = healthy subjects.

Box-and-whisker plots of mismatch score, which is the postsynaptic-to-presynaptic ratio (B′_max:PS_nt) for the same 12 LV regions as in Figure 5. Normals = healthy subjects.