Document Detail


Cardiac autonomic dysfunction in Brugada syndrome.
MedLine Citation:
PMID:  11839625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with Brugada syndrome present with characteristic ECG abnormalities (atypical right bundle-branch block and ST-segment elevation) and life-threatening ventricular tachyarrhythmias despite structurally normal hearts. Involvement of the autonomic nervous system is suggested by the occurrence of ventricular tachyarrhythmias and sudden death at rest or during sleep and by changes of typical ECG signs under pharmacological modulation of the myocardial autonomic tone. METHODS AND RESULTS: This study investigated the presynaptic cardiac neuronal reuptake of norepinephrine (uptake 1) in 17 patients with Brugada syndrome and 10 age-matched control subjects with the use of the norepinephrine analogue [123I]m-iodobenzylguanidine (123I-MIBG), single-photon emission CT (SPECT), and quantitative 33-segment bull's-eye analysis. Regionally reduced 123I-MIBG uptake was present in 8 (47%) of 17 patients with Brugada syndrome but in none of the control subjects. Quantitative analysis showed segmental reduction of 123I-MIBG uptake in the inferior and septal left ventricular wall in patients with Brugada syndrome compared with control subjects (P<0.05). No correlation was found between the findings of 123I-MIBG-SPECT and clinical characteristics of the study patients. CONCLUSIONS: The present study demonstrated an abnormal 123I-MIBG uptake in patients with Brugada syndrome, indicating presynaptic sympathetic dysfunction of the heart. These findings may have potential impact on the pathophysiology and arrhythmogenesis in patients with Brugada syndrome. Future quantitative investigations of the presynaptic and postsynaptic sympathetic and parasympathetic branches of the cardiac autonomic nervous system may clarify whether these observations represent a primary adrenergic dysfunction or an imbalance between sympathetic and parasympathetic innervation of the heart.
Authors:
Thomas Wichter; Peter Matheja; Lars Eckardt; Peter Kies; Klaus Schäfers; Eric Schulze-Bahr; Wilhelm Haverkamp; Martin Borggrefe; Otmar Schober; Günter Breithardt; Michael Schäfers
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  105     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-12     Completed Date:  2002-02-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  702-6     Citation Subset:  AIM; IM    
Affiliation:
Hospital of the Westfälische Wilhelms-University, Department of Cardiology and Angiology, Münster, Germany. wichtet@uni-muenster.de
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use,  pharmacokinetics
Adult
Aged
Autonomic Nervous System / cytology,  drug effects,  metabolism
Autonomic Nervous System Diseases / complications,  diagnosis*,  physiopathology*
Bundle-Branch Block / complications,  physiopathology
Death, Sudden, Cardiac / etiology
Electrocardiography*
Female
Heart / innervation*,  physiopathology*
Heart Ventricles / physiopathology
Humans
Iodine Radioisotopes
Male
Middle Aged
Neurons / metabolism
Norepinephrine / metabolism
Presynaptic Terminals / metabolism
Radiopharmaceuticals / diagnostic use,  pharmacokinetics
Syndrome
Tachycardia, Ventricular / complications,  physiopathology
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 51-41-2/Norepinephrine; 77679-27-7/3-Iodobenzylguanidine
Comments/Corrections
Comment In:
Circulation. 2002 Sep 24;106(13):e59-60; author reply e59-60   [PMID:  12270878 ]

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


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