Document Detail


Assessment of takotsubo (ampulla) cardiomyopathy using iodine-123 metaiodobenzylguanidine scintigraphy.
MedLine Citation:
PMID:  17135004     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the role of cardiac sympathetic innervation in patients whose clinical features consisted of chest pain, transient ST-segment elevation, left ventricular apical akinesis, minimal elevation of cardiac enzymes, and onset of symptoms shortly after a severe stress condition. MATERIAL AND METHODS: Five female patients, mean age 67+/-14 years, underwent thoracic 123I-MIBG (planar and SPECT) and 67Ga citrate (planar) scans within 5 days after the onset of symptoms. The 123I-MIBG myocardial washout rate between early (30 min) and delayed (3 hours) planar images was calculated. All patients presented findings consistent with takotsubo-like syndrome. Echocardiograms showed the characteristic wall motion pattern of significant apical dysfunction. Acute-phase coronary angiographies revealed a non-obstructive pattern. A peculiar apical akinesis and basal normokinesis were observed on the ventriculograms. RESULTS: Impairment of cardiac neuronal uptake of 123I-MIBG based on a reduction of the heart-to-mediastinum uptake ratio was observed in all patients, while the washout rate was raised in four patients. All patients presented an apical uptake defect in the 123I-MIBG SPECT and planar images and a normal 67Ga scintigraphy. CONCLUSION: Our data indicate that ampulla cardiomyopathy (AC) is associated with a cardiac sympathetic innervation deficit characterized by a reduced global 123I-MIBG uptake and an apical uptake defect. The lack of 67Ga uptake in the acute phase of this syndrome indicates that AC is probably not associated with an inflammatory process.
Authors:
Pinheiro M C Pessoa; Salles S Xavier; Souza Leão R Lima; J Mansur; Altino S de Almeida; Pires A C Carvalho; B Gutfilen; Barbosa L M da Fonseca
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  47     ISSN:  0284-1851     ISO Abbreviation:  Acta Radiol     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-30     Completed Date:  2007-02-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  1029-35     Citation Subset:  IM    
Affiliation:
Departamento de Radiologia, Faculdade de Medicina, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use*
Aged
Cardiomyopathies / radiography,  radionuclide imaging*,  ultrasonography
Citrates / diagnostic use
Coronary Angiography
Echocardiography
Female
Gallium / diagnostic use
Humans
Middle Aged
Myocardial Stunning / radiography,  radionuclide imaging*,  ultrasonography
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Syndrome
Tomography, Emission-Computed, Single-Photon*
Ventricular Dysfunction, Left / radiography,  radionuclide imaging*,  ultrasonography
Chemical
Reg. No./Substance:
0/Citrates; 0/Radiopharmaceuticals; 27905-02-8/gallium citrate; 7440-55-3/Gallium; 77679-27-7/3-Iodobenzylguanidine

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