Cardiac Sympathetic Dysfunction Correlates With Abnormal Myocardial Contractile Reserve in Dilated Cardiomyopathy Patients

Ohshima, Satoru; Isobe, Satoshi; Izawa, Hideo; Nanasato, Mamoru; Ando, Akitada; Yamada, Akira; Yamada, Kento; Kato, Tomoko S.; Okihara, Koji; Noda, Akiko; Nishizawa, Tsutomu; Katô, Katsuhiko; Nagata, Kazuya; Okumura, Kenji; Murohara, Toyoaki; Yokota, Mitsuhiro

doi:10.1016/j.jacc.2005.08.046

Cited by 40 publications

(21 citation statements)

References 30 publications

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“…An association has been found between the heart-to-mediastinum ratio on the delayed image, the washout rate, brain natriuretic peptide serum norepinephrine concentration, and heart-type fatty acid binding protein, which is a marker for ongoing myocardial damage (83,84). Another report indicated that the heart-tomediastinum ratio reflected myocardial contractile reserve (85). Furthermore, it was successfully used in monitoring the effect of ameliorating treatment; the improvement rating has been shown to be an excellent predictor of prognosis (86,87).…”

Section: I-labeled Mibg Scintigraphymentioning

confidence: 99%

Scintigraphic Techniques for Early Detection of Cancer Treatment–Induced Cardiotoxicity

et al. 2011

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New antitumor agents have resulted in significant survival benefits for cancer patients. However, several agents may have serious cardiovascular side effects. Left ventricular ejection fraction measurement by 99m Tc multigated radionuclide angiography is regarded as the gold standard to measure cardiotoxicity in adult patients. It identifies left ventricular dysfunction with high reproducibility and low interobserver variability. A decrease in left ventricular ejection fraction, however, is a relatively late manifestation of myocardial damage. Nuclear cardiologic techniques that visualize pathophysiologic processes at the tissue level could detect myocardial injury at an earlier stage. These techniques may give the opportunity for timely intervention to prevent further damage and could provide insights into the mechanisms and pathophysiology of cardiotoxicity caused by anticancer agents. This review provides an overview of past, current, and promising newly developed radiopharmaceuticals and describes the role and recent advances of scintigraphic techniques to measure cardiotoxicity. Both first-order functional imaging techniques (visualizing mechanical [pump] function), such as 99m Tc multigated radionuclide angiography and 99m Tc gated blood-pool SPECT, and third-order functional imaging techniques (visualizing pathophysiologic and neurophysiologic processes at the tissue level) are discussed. Third-order functional imaging techniques comprise 123 I-metaiodobenzylguanidine scintigraphy, which images the efferent sympathetic nervous innervations; sympathetic neuronal PET, with its wide range of tracers; 111 In-antimyosin, which is a specific marker for myocardial cell injury and necrosis; 99m Tc-annexin V scintigraphy, which visualizes apoptosis and cell death; fatty-acid-use scintigraphy, which visualizes the storage of free fatty acids in the lipid pool of the cytosol (which can be impaired by cardiotoxic agents); and 111 In-trastuzumab imaging, to study trastuzumab targeting to the myocardium. To define the prognostic importance and clinical value of each of these functional imaging techniques, prospective clinical trials are warranted.

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Section: I-labeled Mibg Scintigraphymentioning

confidence: 99%

Scintigraphic Techniques for Early Detection of Cancer Treatment–Induced Cardiotoxicity

et al. 2011

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“…30 Contractile reserve also mirrors sympathetic dysfunction, 31 which makes this an inexpensive surrogate for tests of sympathetic status. In the future, this information may be used in tailoring HF therapy to the status of individual patients.…”

Section: Contractile Reservementioning

confidence: 99%

“…44 MR spectroscopy is able to measure energy metabolism through analysis of myocardial ATP and phosphocreatine. 45 However, 31 P-MR spectra may be difficult to quantify, and although the technique has been performed with standard 1.5-T systems, the signal-to-noise ratio is more favorable at high magnetic field strength. Although spectroscopy is likely to shed light on important mechanisms in congestive HF, its clinical adoption seems unlikely at present.…”

Section: Marwick and Schwaiger Cardiovascular Imaging In Heart Failurementioning

confidence: 99%

The Future of Cardiovascular Imaging in the Diagnosis and Management of Heart Failure, Part 1

Marwick

Schwaiger

2008

Circ: Cardiovascular Imaging

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“…The failing heart is characterized by reduced distribution and washout of MIBG [35] . Abnormal MIBG uptake, calculated by the ratio of heart and mediastinum uptake, correlates with reduced myocardial contractile reserve in patients with dilated cardiomyopathy [36] . Similarly, c-11-HED, a PET-based NE analog, is significantly correlated to the NET density, and has been used to demonstrate regional variations of NE content in cardiomyopathy [37] .…”

Section: Myocardial Metaiodobenzylguanidine Scintigraphy and Its Clinmentioning

confidence: 99%

Cardiac sympathetic nerve terminal function in congestive heart failure

Liang

2007

Acta Pharmacologica Sinica

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Increased cardiac release of norepinephrine (NE) and depleted cardiac stores of NE are two salient features of the human failing heart. Researches from my laboratory have shown that these changes are accompanied by a functional defect of NE uptake in the cardiac sympathetic nerve terminals. Our studies have shown that the decrease of NE uptake is caused by reduction of NE transporter density in the sympathetic nerve endings, and this change is responsible, at least in part, for the increased myocardial interstitial NE, decreased myocardial adrenoceptor density, and increased myocyte apoptosis in experimental cardiomyopathies. We have also provided evidence in both intact animals and cultured PC12 cells that the decrease of NE transporter is induced by the actions of oxidative metabolites of exogenous NE, involving endoplasmic reticulum stress and impaired N-glycosylation of the NE transporter. This change in the cardiac sympathetic NE uptake function, as demonstrated by [ 123 I] metaiodobenzylguanidine in human studies, may not only serve as an important prognostic variable in patients with congestive heart failure, but also be used as a surrogate for the efficacies of various therapeutic interventions for heart failure. Finally, increasing evidence suggests and further studies are needed to show that the cardiac sympathetic nerve terminal function may be a direct target for pharmacologic treatment of congestive heart failure.

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Cardiac Sympathetic Dysfunction Correlates With Abnormal Myocardial Contractile Reserve in Dilated Cardiomyopathy Patients

Abstract: Abnormal myocardial 123I-MIBG accumulation is related to an impaired myocardial contractile reserve and down-regulation of SERCA2 mRNA in DCM. Myocardial 123I-MIBG scintigraphy can be useful in noninvasively evaluating myocardial contractile reserve in patients with mild to moderate DCM.

Cited by 40 publications

References 30 publications

Scintigraphic Techniques for Early Detection of Cancer Treatment–Induced Cardiotoxicity

Scintigraphic Techniques for Early Detection of Cancer Treatment–Induced Cardiotoxicity

The Future of Cardiovascular Imaging in the Diagnosis and Management of Heart Failure, Part 1

Cardiac sympathetic nerve terminal function in congestive heart failure

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