Document Detail


Assessment of central chemosensitivity and cardiac sympathetic nerve activity using I-123 MIBG imaging in central sleep apnea syndrome in patients with dilated cardiomyopathy.
MedLine Citation:
PMID:  17373339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Iodine-123 MIBG imaging has been used to study cardiac sympathetic function in various cardiac diseases. Central sleep apnea syndrome (CSAS) occurs frequently in patients with chronic heart failure (CHF) and is reported to be associated with a poor prognosis. One of the mechanisms of its poor prognosis may be related to impaired cardiac sympathetic activity. However, the relationship between chemosensitivity to carbon dioxide, which is reported to correlate with the severity of CSAS, and cardiac sympathetic activity has not been investigated. Therefore, this study was undertaken to assess cardiac sympathetic function and chemosensitivity to carbon dioxide in CHF patients. METHODS: The oxygen desaturation index (ODI) was evaluated in 21 patients with dilated cardiomyopathy (male/female: 19/2, LVEF < 45%, 65 +/- 12 yr). Patients with an ODI > 5 times/h underwent polysomnography. Patients with an apnea hypopnea index > 15/h but without evidence of obstructive apnea were defined as having CSAS. Early (15 min) and delayed (4 hr) planar MIBG images were obtained from these patients. The mean counts in the whole heart and the mediastinum were obtained. The heart-to-mediastinum count ratio of the delayed image (H/M) and the corrected myocardial washout rate (WR) were also calculated. The central chemoreflex was assessed with the rebreathing method using a hypercapnic gas mixture (7% CO2 and 93% O2). RESULTS: Ten of the 21 patients had CSAS. The H/M ratio was similar in patients both with and without CSAS (1.57 +/- 0.18 vs. 1.59 +/- 0.14, p = 0.82). However, the WR was higher in patients with CSAS than in patients without CSAS (40 +/- 8% vs. 30 +/- 12%, p < 0.05). ODI significantly correlated with central chemosensitivity to carbon dioxide. Moreover, there was a highly significant correlation between WR and central chemosensitivity (r = 0.65, p < 0.05). However, there was no correlation between ODI and the WR (r = 0.36, p = 0.11). CONCLUSIONS: Cardiac sympathetic nerve activity in patients with CHF and CSAS is impaired. However, central sleep apnea might not directly increase cardiac sympathetic nerve activity. We suggest that central chemosensitivity, which is considered to be one of the mechanisms of CSAS, is correlated with cardiac sympathetic nerve activity.
Authors:
Kentaro Meguro; Takuji Toyama; Hitoshi Adachi; Shigeru Ohshima; Koichi Taniguchi; Ryozo Nagai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  21     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-03-21     Completed Date:  2007-04-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  73-8     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Tokyo University Graduate School of Medicine, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan. meguro@med.email.ne.jp
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine*
Aged
Carbon Dioxide / metabolism
Cardiomyopathy, Dilated / metabolism,  radionuclide imaging*
Female
Heart / innervation*
Humans
Iodine Radioisotopes*
Male
Middle Aged
Sleep Apnea, Central / metabolism,  radionuclide imaging*
Sympathetic Nervous System / metabolism,  radionuclide imaging*
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes; 124-38-9/Carbon Dioxide; 77679-27-7/3-Iodobenzylguanidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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