Document Detail

Cardiac adrenergic nerve function and microvascular dysfunction in patients with cardiac syndrome X.
MedLine Citation:
PMID:  19164330     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess whether abnormalities in cardiac uptake of (123)I-metaiodobenzylguanidine (MIBG) correlate with coronary microvascular dysfunction in patients with cardiac syndrome X (CSX). SETTING: University hospital. PATIENTS: 29 patients (aged 59 (SD 7) years, 11 men) with typical CSX and a matched group of 20 healthy subjects (aged 56 (7) years, 8 men) were studied. INTERVENTIONS: Planar and single photon emission computed tomography (SPECT) MIBG myocardial scintigraphy was performed in all subjects. Coronary flow response (CFR) to adenosine and to cold pressor test (CPT) in the left anterior descending (LAD) coronary artery was assessed in all CSX patients and in 12 controls by transthoracic Doppler echocardiography. MAIN OUTCOME MEASURES: Abnormalities in cardiac MIBG scintigraphy were observed in 25 CSX patients (86.2%), but in no healthy control (p<0.001). Compared to controls, CSX patients showed a lower heart/mediastinum (H/M) ratio of MIBG uptake (1.69 (0.24) vs 2.2 (0.3), p<0.001) and a higher cardiac MIBG defect score (25 (22) vs 4 (2), p = 0.002). Both CFR to adenosine (3.31 (1.1) vs 1.94 (0.6), p<0.001) and CFR to CPT (2.35 (0.5) vs 1.63 (0.4), p<0.001) were lower in CSX patients than in controls. In CSX patients, however, no correlation was found between MIBG H/M ratio and CFR to adenosine (r = 0.17; p = 0.38) and to CPT (r = -0.28; p = 0.13), as well as between MIBG uptake score in the LAD territory and CFR to adenosine (r = 0.14; p = 0.47) and to CPT (r = 0.06; p = 0.73). CONCLUSION: Our data show striking abnormalities in cardiac adrenergic nerve function and in coronary microvascular function in CSX patients. However, no significant relation between the two abnormalities was found. Further studies are needed to clarify the mechanisms and the role of MIBG defects in CSX patients.
A Di Monaco; I Bruno; A Sestito; P Lamendola; L Barone; A Bagnato; R Nerla; C Pisanello; A Giordano; G A Lanza; F Crea
Publication Detail:
Type:  Journal Article     Date:  2009-01-22
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  95     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-16     Completed Date:  2009-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  550-4     Citation Subset:  AIM; IM    
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy.
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MeSH Terms
3-Iodobenzylguanidine / diagnostic use,  pharmacokinetics*
Adenosine / diagnostic use
Adrenergic Fibers / metabolism*,  physiology,  radionuclide imaging
Case-Control Studies
Cold Temperature / adverse effects
Coronary Circulation / drug effects
Electrocardiography / drug effects
Heart / radionuclide imaging
Microcirculation / drug effects
Microvascular Angina / metabolism*,  physiopathology,  radionuclide imaging
Middle Aged
Myocardium / metabolism*
Positron-Emission Tomography
Radiopharmaceuticals / diagnostic use,  pharmacokinetics*
Vasodilator Agents / diagnostic use
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Vasodilator Agents; 58-61-7/Adenosine; 77679-27-7/3-Iodobenzylguanidine
Comment In:
Heart. 2009 Apr;95(7):521   [PMID:  19164331 ]

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

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