Abstract
Iodine-123-metaiodobenzylguanidine (123I-MIBG) has been used to assess the integrity and function of the cardiac sympathetic nervous system in patients with heart failure. Heart-type fatty acid binding protein (H-FABP) is released into the circulation when the myocardium is injured, and H-FABP has been recently used as a novel marker for the diagnosis of ongoing myocardial damage.
Objective
The aim of the present study was to compare cardiac sympathetic nervous activity assessed by123I-MIBG imaging with serum levels of H-FABP in patients with heart failure.
Methods
Fifty patients with chronic heart failure were studied.123I-MIBG imaging was carried out at 30 min (early) and 240 min (delayed) after the tracer injection. We measured serum levels of H-FABP using a sandwich enzyme linked immunosorbent assay.
Results
Heart to mediastinum (H/M) ratios of123I-MIBG decreased and washout rate increased with higher New York Heart Association (NYHA) functional class. H-FABP, norepinephrine and brain natriuretic peptide (BNP) levels increased as the severity of NYHA class advanced. Delayed H/M ratio was significantly correlated with H-FABP (r = -0.296, p = 0.029) and BNP (r = -0.335, p = 0.0213). Myocardial washout rate of123I-MIBG was also correlated with H-FABP (r = 0.469, p < 0.001), norepinephrine (r = 0.433, p = 0.005), and BNP (r = 0.465, p = 0.001).
Conclusions
These data suggest that cardiac sympathetic nervous activation was associated with ongoing cardiomyocyte damage characterized by an elevated serum level of H-FABP in patients with heart failure.123I-MIBG imaging is an appropriate approach to evaluate non-invasively not only cardiac sympathetic nervous activity, but also latent ongoing myocardial damage in the failing heart.
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References
Packer M. The neurohormonal hypothesis: a theory to explain the mechanism of disease progression in heart failure.J Am Coll Cardiol 1992; 20: 248–254.
Bohm M, La Rosee K, Schwinger RH, Erdmann E. Evidence for reduction of norepinephrine uptake sites in the failing human heart.J Am Coll Cardiol 1995; 25: 146–153.
Eisenhofer G, Friberg P, Rundqvist B, Quyyumi AA, Lambert G, Kaye DM, et al. Cardiac sympathetic nerve function in congestive heart failure.Circulation 1996; 93: 1667–1676.
Sisson JC, Shapiro B, Meyers L, Mallette S, Mangner TJ, Wieland DM, et al. Metaiodobenzylguanidine to map scintigraphically the adrenergic nervous system in man.J Nucl Med 1987; 28: 1625–1636.
Schofer J, Spielmann R, Schuchert A, Weber K, Schluter M. Iodine-123 metaiodobenzylguanidine scintigraphy: a noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy.J Am Coll Cardiol 1988; 12:1252–1258.
Glowniak JV, Turner FE, Gray LL, Palac RT, Lagunas-Solar MC, Woodward WR. Iodine-123 metaiodobenzylguanidine imaging of the heart in idiopathic congestive cardiomyopathy and cardiac transplants.J Nucl Med 1989; 30: 1182–1191.
Henderson EB, Kahn JK, Corbett JR, Jansen DE, Pippin JJ, Kulkarni P, et al. Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy.Circulation 1988; 78: 1192–1199.
Merlet P, Valette H, Dubois-Rande JL, Moyse D, Duboc D, Dove P. et al. Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure.J Nucl Med 1992; 33: 471–477.
Imamura Y, Ando H, Mitsuoka W, Egashira S, Masaki H, Ashihara T, et al. Iodine-123 metaiodobenzylguanidine images reflect intense myocardial adrenergic nervous activity on congestive heart failure independent of underlying cause.J Am Coll Cardiol 1995; 26: 1594–1599.
Imamura Y, Ando H, Ashihara T, Fukuyama T. Myocardial adrenergic nervous activity is intensified in patients with heart failure without left ventricular volume or pressure overload.J Am Coll Cardiol 1996; 28: 371–375.
Nakata T, Miyamoto K, Doi A, Sasao H, Wakabayashi T, Kobayashi H, et al. Cardiac death prediction and impaired cardiac sympathetic innervation assessed by MIBG in patients with failing and nonfailing hearts.J Nucl Cardiol 1998; 5: 579–590.
Merlet P, Benvenuti C, Moyse D, Pouillart F, Dubois-Rande JL, Duval AM, et al. Prognostic value of MIBG imaging in idiopathic dilated cardiomyopathy.J Nucl Med 1999;40:917–923.
Imamura Y, Fukuyama T, Mochizuki T, Miyagawa M, Watanabe K. Prognostic value of iodine-123-metaiodo-benzylguanidine imaging and cardiac natriuretic peptide levels in patients with left ventricular dysfunction resulting from cardiomyopathy.Jpn Circ J 2001; 65: 155–160.
Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, et al. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure.N Engl J Med 1984; 311:819–823.
Tsutamoto T, Wada A, Maeda K, Hisanaga T, Maeda Y, Fukai D, et al. Attenuation of compensation of endogenous cardiac natriuretic peptide system in chronic heart failure: prognostic role of plasma brain natriuretic peptide concentration in patients with chronic symptomatic left ventricular dysfunction.Circulation 1997; 96: 509–516.
Setsuta K, Seino Y, Takahashi N, Ogawa T, Sasaki K, Harada A, et al. Clinical significance of elevated levels of cardiac troponin T in patients with chronic heart failure.Am J Cardiol 1999; 84: 608–611.
Tanaka T, Hirota Y, Sohmiya K, Nishimura S, Kawamura K. Serum and urinary human heart fatty acid-binding protein in acute myocardial infarction.Clin Biochem 1991; 24: 195–201.
Kleine AH, Glatz JF, Van Nieuwenhoven FA, Van der Vusse GJ. Release of heart fatty acid-binding protein into plasma after acute myocardial infarction in man.Mol Cell Biochem 1992; 116: 155–162.
Glatz JF, Klein AH, van Nieuwenhoven FA, Hermens WT, van Dieijen-Visser MP, van Vusse GJ. Fatty-acid-binding protein as a plasma marker for the estimation of myocardial infarct size in humans.Br Heart J 1994; 71: 135–140.
Arimoto T, Takeishi Y, Shiga R, Fukui A, Tachibana H, Nozaki N. et al. Prognostic value of elevated circulating heart-type fatty acid binding protein in patients with congestive heart failure.J Card Fail 2005; 11: 56–60.
Matsui T, Tsutamoto T, Kinoshita M. Relationship between cardiac123I-metaiodobenzylguanidine imaging and the transcardiac gradient of neurohumoral factors in patients with dilated cardiomyopathy.Jpn Circ J 2001; 65: 1041–1046.
Matsuo S, Nakamura Y, Tsutamoto T, Kinoshita M. Impairments of myocardial sympathetic activity may reflect the progression of myocardial damage or dysfunction in hyper-trophic cardiomyopathy.J Nucl Cardiol 2002; 9:407–412.
Kyuma M, Nakata T, Hashimoto A, Nagao K, Sasao H, Takahashi T, et al. Incremental prognostic implications of brain natriuretic peptide, cardiac sympathetic nerve innervation, and noncardiac disorders in patients with heart failure.J Nucl Med 2004; 45: 155–163.
Arimoto T, Shiga R, Fukui A, Tachibana H, Nozaki N, Hirono O, et al. Prognostic importance of elevated circulating levels of heart-type fatty acid binding protein in patients with congestive heart failure: Comparisons with sympathetic nervous activity assessed by Iodine-123-metaiodo-benzylguanidine. (abstract)Circulation 2003; 108 (Suppl): IV-601.
Takeishi Y, Atsumi H, Fujiwara S, Takahashi K, Tomoike H. ACE inhibition reduces cardiac iodine-123-MIBG release in heart failure.J Nucl Med 1997; 38: 1085–1089.
Atsumi H, Takeishi Y, Fujiwara S, Tomoike H. Cardiac sympathetic nervous disintegrity is related to exercise intolerance in patients with chronic heart failure.Nucl Med Commun 1998; 19: 451–456.
Arimoto T, Takeishi Y, Fukui A, Tachibana H, Nozaki N, Hirono O, et al. Dynamic123I-MIBG SPECT reflects sympathetic nervous integrity and predicts clinical outcome in patients with chronic heart failure.Ann Nucl Med 2004; 18: 145–150.
Schrier RW, Abraham WT. Hormones and hemodynamics in heart failure.N Engl J Med 1999; 341: 577–585.
Sack MN, Rader TA, Park S, Bastin J, McCune SA, Kelly DP. Fatty acid oxidation enzyme gene expression is downregulated in the failing heart.Circulation 1996; 94: 2837–2842.
Recchia FA, McConnell PI, Bernstein RD, Vogel TR, Xu X, Hintze TH. Reduced nitric oxide production and altered myocardial metabolism during the decompensation of pacing-induced heart failure in the conscious dog.Circ Res 1998; 83: 969–979.
Yamauchi S, Takeishi Y, Minamihaba O, Arimoto T, Hirono O, Takahashi H, et al. Angiotensin-converting enzyme inhibition improves cardiac fatty acid metabolism in patients with chronic heart failure.Nucl Med Comm 2003; 24: 901–906.
Binas B, Danneberg H, McWhir J, Mullins L, Clark AJ. Requirement for the heart-type fatty acid binding protein in cardiac fatty acid utilization.FASEB J 1999; 13: 805–812.
Murata K, Kusachi S, Murakami T, Nogami K, Murakami M, Hirohata S, et al. Relation of iodine-123 metaiodobenzyl-guanidine myocardial scintigraphy to endomyocardial biopsy findings in patients with dilated cardiomyopathy.Clin Cardiol 1997; 20: 61–66.
Ishii J, Nomura M, Nakamura Y, Naruse H, Mori Y, Ishikawa T, et al. Risk stratification using a combination of cardiac troponin T and brain natriuretic peptide in patients hospitalized for worsening chronic heart failure.Am J Cardiol 2002;89:691–695.
Setsuta K, Seino Y, Ogawa T, Arao M, Miyatake Y, Takano T. Use of cytosolic and myofibril markers in the detection of ongoing myocardial damage in patients with chronic heart failure.Am J Med 2002; 113: 717–722.
Niizeki T, Takeishi Y, Arimoto T, Okuyama H, Fukui A, Tachibana H, et al. Risk stratification using a combination of heart-type fatty acid binding protein and brain natriuretic peptide in patients hospitalized for congestive heart failure.Circ J 2005; 69: 922–927.
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Arimoto, T., Takeishi, Y., Niizeki, T. et al. Ongoing myocardial damage relates to cardiac sympathetic nervous disintegrity in patients with heart failure. Ann Nucl Med 19, 535–540 (2005). https://doi.org/10.1007/BF02985045
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DOI: https://doi.org/10.1007/BF02985045