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Evaluation of cardiac sympathetic neuronal integrity in diabetic patients using iodine-123 metaiodobenzylguanidine

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Abstract

Autonomic dysfunction is associated with increased mortality in diabetic patients. To evaluate the cardiac autonomic dysfunction in these patients, a prospective study was undertaken using iodine-123 metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET). The study groups consisted of ten diabetic patients with cardiac autonomic neuropathy (group 1) and six without autonomic neuropathy (group II). Autonomic nervous function tests, thallium scan, radionuclide ventriculographic data including ejection fraction and wall motion study, and 24-h urine catecholamine levels were evaluated.123I-MIBG SPET was performed at 30 min and 4 h following injection of 3 mCi of123I-MIBG in groups I and II and in normal subjects (n=4). On planar images, the heart to mediastinum (H/M) ratio was measured. Defect pattern and severity of MIBG uptake were qualitatively analysed on SPET. Compared with control subjects, diabetic patients had a reduced H/M ratio regardless of the presence of clinical autonomic neuropathy. There was no difference in H/M ratio between groups I and II. On SPET images, focal or diffuse defects were demonstrated in all patients in group I, and in five of the six patients in group II. The extent of defects tended to be more pronounced in group I than in group II. In conclusion, SU1-MIBG scan was found to be a more sensitive method than clinical autonomic nervous function tests for the detection of autonomic neuropathy in diabetes.

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, 120-752, Seoul, Korea

    Sun Jung Kim, Jong Doo Lee, Young Hoon Ryu, Pyoung Jeon, Yong Woon Shim, Hyung Sik Yoo & Chang Yun Park

  2. Department of Endocrinology, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, 120-752, Seoul, Korea

    Seung Gil Lim

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  1. Sun Jung Kim
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  2. Jong Doo Lee
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  3. Young Hoon Ryu
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  4. Pyoung Jeon
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  6. Hyung Sik Yoo
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  7. Chang Yun Park
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Kim, S.J., Lee, J.D., Ryu, Y.H. et al. Evaluation of cardiac sympathetic neuronal integrity in diabetic patients using iodine-123 metaiodobenzylguanidine. Eur J Nucl Med 23, 401–406 (1996). https://doi.org/10.1007/BF01247368

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