Relationship Between Cardiac ^<123>I-Metaiodobenzylguanidine Imaging and the Transcardiac Gradient of Neurohumoral Factors in Patients With Dilated Cardiomyopathy

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Cardiac sympathetic nervous function is altered in congestive heart failure(CHF)and the uptake and washout rate of cardiac ^<123>I-metaiodobenzylguanidine(MIBG)are useful markers for evaluating the severity of it. To assess what parameters predict decreased uptake or increased washout rate of MIBG, the concentrations of neurohumoral factor in both the aorta(Ao)and coronary sinus(CS)were measured, as well as hemodynamic parameters by catheterization, in patients with dilated cardiomyopathy(DCM). MIBG imaging was performed within 1 week of cardiac catheterization. Regarding MIBG parameters, the correlation with the transcardiac gradient of norepinephrine(NE), brain natriuretic peptide(BNP)and hemodynamics was investigated. Stepwise multivariate regression analysis was used to determine which variables closely correlated with cardiac MIBG parameters. There was a significant increase in the NE level between the Ao(446pg/ml)and the CS(727 pg/ml). According to stepwise multivariate regression analysis, the heart/mediastinum(H/M)ratio independently correlated with the transcardiac gradient of BNP(r=-0.480, p<0.01), and the washout rate independently correlated with the transcardiac gradient of NE(r=0.481, p<0.01). These findings indicate that the H/M ratio may reflect the transcardiac gradient of BNP, which implies the degree of left ventricular dysfunction and/or damage and the washout rate may reflect altered cardiac sympathetic nerve terminal in DCM patients with CHF, suggesting that both the H/M ratio and washout rate provide important information about the failing ventricle.
社団法人日本循環器学会の論文
2001-11-20

Relationship Between Cardiac ^<123>I-Metaiodobenzylguanidine Imaging and the Transcardiac Gradient of Neurohumoral Factors in Patients With Dilated Cardiomyopathy

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