Reduced myocardial 123I-metaiodobenzylguanidine uptake in newly diagnosed IDDM patients

Schnell, Oliver; Muhr, Daniela; Weiss, Mia C.; Dresel, S.; Haslbeck, M.; Standl, Eberhard

doi:10.2337/diabetes.45.6.801

Cited by 47 publications

(53 citation statements)

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“…A new technique for the evaluation of cardiac autonomic dysfunction is the use of 123 I-Meta-iodobenzlguanidine ( 123 I-MIBG) as marker for adrenaline in the terminal portion of sympathetic neurones; the capture of the iodine decay is then analysed by single photon emission computer tomography (SPECT). A study by Schnell et al [45] looked at 22 newly diagnosed patients with Type 1 diabetes with 123 I-MIBG scanning and found that 77% of the diabetic subgroup had abnormalities compared with none of the control group. Using more conventional measures of autonomic function only 9% demonstrated any disturbance of cardiac autonomic function.…”

Section: Type 1 Diabetesmentioning

confidence: 99%

The clinical implications of diabetic heart disease

Butler

MacDonald

Struthers

et al. 1998

European Heart Journal

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Section: Type 1 Diabetesmentioning

confidence: 99%

The clinical implications of diabetic heart disease

Butler

MacDonald

Struthers

et al. 1998

European Heart Journal

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“…To assess cardiac autonomic neuropathy, Dr. Standl used the innovative technique of scintigraphic OJ/I × 2 detection with 123 metaiodobenzylguanidine ( 123 MIBG) in newly diagnosed patients with more prolonged IDDM. He found signs of sympathetic dysinnervation especially in the posterior myocardial region in 77 % of newly diagnosed IDDM patients, whereas, only 3 % of these patients showed all ECG-based cardiac autonomic neuropathy [12]. Of note, glycaemic control was able to restore this partial impairment.…”

Section: Philippe Froguel: Genetics Of Macrovascular Diseasementioning

confidence: 99%

Cardiovascular complications of diabetes

et al. 1997

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Cardiovascular complications are the leading causes of mortality in both insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). The severity of this problem is clearly illustrated by the finding that IDDM patients suffer from mortality rates many times higher than of the general population [1]. In spite of the gravity of this complication, there is a relative paucity of data specifically on the pathogenesis, prevention and the treatment of the cardiovascular lesions in diabetes. The goal of this article is to highlight certain areas which are pertinent to diabetic cardiovascular complications and to suggest research goals which will bring understanding of the pathogenesis of this grave complication and its potential treatments.George L. King: Hyperglycaemia and insulin resistance: how do they increase cardiovascular risk in diabetic patients?A major cause of morbidity and mortality in diabetic patients is macrovascular disease affecting the heart and large vessels. In diabetes there is an acceleration of atherosclerosis with excessive extracellular matrix thickening. In the heart, the major pathology is atherosclerosis of the coronary arteries, and the fibrosis, and hypertrophy of the myocardium. Hyperglycaemia, hyperlipidaemia and insulin resistance are some of the recognized risk factors [2,3]. The basic abnormalities are in glucose metabolism and insulin action which can lead to a whole range of vascular changes in the areas of coagulation, contractility, leukocyte adhesions, and smooth muscle cell proliferation. The mechanisms by which hyperglycaemia causes vascular dysfunction are probably multiple. These mechanisms include non-enzymatic glycation, oxidative stress, polyol-myoinositol alteration, and activation of diacylglycerol (DAG) and protein kinase C (PKC) pathways. The role of the DAG and PKC pathways which regulate many vascular functions were discussed since this is the newest of the four main theories.Studies over the last 7 years have shown that there is an increase in DAG levels and activation of PKC activities in vascular cells from the retina, glomeruli, aorta and the heart when exposed to high glucose levels in culture or in the diabetic state in vivo [4]. Increased glycolysis can elevate DAG which in turn activates protein kinase C in the vascular cells. The b I and II isoforms of PKC are predominantly increased in the vascular cells induced by diabetes and hyperglycaemia involving PKCbI in the renal glomeruli and PKCbII in the rest of the vasculature.The increase in DAG levels and activation of PKCb isoforms have been associated with a variety of biochemical, cellular and physiological changes in the vasculature. These changes lead to an increase in the transcription rate of transforming growth factor b (TGFb)which regulates increases in the synthesis of extra-cellular matrix protein such as type IV and VI collagen, and fibronectin resulting in capillary basement membrane thickening which is observed in all diabetic animals and patients [5]. The abnormal amount of base...

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“…Limited studies demonstrate that decreased "uptake" and excessive "washout" of MIBG-derived radioactivity is an adverse prognostic finding in a spectrum of conditions including DM and that scintigraphic data are affected by the quality of glucose control (class III). Cost of scintigraphic studies is considerable [50,78,79].…”

Section: (Class Iii)mentioning

confidence: 99%

Diabetic Cardiovascular Neuropathy

Serhiyenko¹,

Publisher²,

Serhiyenko³

2018

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Cardiac autonomic neuropathy (CAN) is a serious complication of diabetes mellitus, that is strongly associated with increased risk of cardiovascular mortality. Although it is common complication, the significance of CAN has not been fully appreciated and there are no unified treatment algorithms for today. In this review we have analyzed the existing data about the known risk factors, screening and diagnostic algorithm, staging of CAN and possible treatment, including effectiveness of lifestyle modification, intensive glycemic control; treatment of diabetic dyslipidemia; antioxidants; vitamins; correction of vascular endothelial dysfunction; prevention and treatment of thrombosis; treatment of orthostatic hypotension. Conclusion 88References 89 Abbreviations list 108Victoria Serhiyenko, Alexandr Serhiyenko 7 ABOUT THE AUTHORSVictoria A Serhiyenko, MD, PhD in Medicine Sciences, DMSc, Associate Professor of the Department of Endocrinology, Lviv National Medical University named by Danylo Halitsky, Lviv, Ukraine. At the moment she is working on the problems concerted with the revelation of the correlating connections between activities of some metabolic, hormonal and other parameter, and state of the proand anti-inflammatory factors in blood in patients with diabetes mellitus which depends on the character of diabetic complications. The second part of his scientific work is the research of the effectively of the benfotiamine in treatment and prevention of diabetic complications in clinical practice.Victoria Serhiyenko has published 238 scientific papers. These works are devoted to the problems of pathogenesis, diagnosis and treatment, prevention of the diabetic cardiovascular autonomic neuropathy.Alexandr A Serhiyenko, MD, PhD in Medicine Sciences, DMSc, Professor of the Department of Endocrinology, Lviv National Medical University named by Danylo Halitsky, Lviv, Ukraine. At the moment he is working on the problems concerted with the revelation of the correlating connections between activities of some metabolic parameters in patients with diabetes mellitus which depends on the character of diabetic complications. The second part of her scientific work is the research of the effectively of the benfotiamine in treatment and prevention of diabetic complications in clinical practice.Alexandr Serhiyenko has published 613 scientific papers. These works are devoted to the problems of pathogenesis, diagnosis and treatment, prevention of the diabetic complications.

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Reduced myocardial 123I-metaiodobenzylguanidine uptake in newly diagnosed IDDM patients

Cited by 47 publications

References 0 publications

The clinical implications of diabetic heart disease

The clinical implications of diabetic heart disease

Cardiovascular complications of diabetes

Diabetic Cardiovascular Neuropathy

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