| Extent of cardiac sympathetic neuronal damage is determined by the area of ischemia in patients with acute coronary syndromes. | |
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MedLine Citation:
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PMID: 10840008 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Prior studies have demonstrated that acute ischemic injury causes sympathetic neuronal damage exceeding the area of necrosis. The aim of this study was to test the hypothesis that sympathetic neuronal damage measured by (123)I-metaiodobenzylguanidine (MIBG) imaging would be determined by the area of ischemia as reflected by area at risk in patients undergoing reperfusion therapy for acute coronary syndromes. METHODS AND RESULTS: In 12 patients, the myocardium at risk was assessed by (99m)Tc-sestamibi SPECT before reperfusion, and infarct size was measured by follow-up (99m)Tc-sestamibi SPECT 1 week later. All patients also underwent (123)I-MIBG SPECT within a mean of 11 days after onset. The SPECT image analysis was based on a semiquantitative polar map approach. Defect size on the (123)I-MIBG or (99m)Tc-sestamibi SPECT was measured for the left ventricle (LV) with the use of a threshold of -2.5 SD from the mean value of a normal database and was expressed as %LV. The (123)I-MIBG defect size (47+/-18%LV) was larger than the infarct size (27+/-23%LV, P<0. 001) but was similar to the risk area (49+/-18%LV, P=NS). Furthermore, the (123)I-MIBG defect size was closely correlated with the risk area (r=0.905, P<0.001). CONCLUSIONS: Sympathetic neuronal damage measured by (123)I-MIBG SPECT is larger than infarct size and is closely related to risk area, suggesting high sensitivity of neuronal structures to ischemia compared with myocardial cells. |
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Authors:
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I Matsunari; U Schricke; F M Bengel; H U Haase; P Barthel; G Schmidt; S G Nekolla; A Schoemig; M Schwaiger |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 101 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2000 Jun |
Date Detail:
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Created Date: 2000-06-21 Completed Date: 2000-06-21 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2579-85 Citation Subset: AIM; IM |
Affiliation:
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Nuklearmedizinische Klinik und Poliklinik, 1. Medizinische Klinik, Technische Universität München, Klinikum rechts der Isar, Munich, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Coronary Angiography Coronary Disease / pathology*, radionuclide imaging Creatine Kinase / blood Female Heart / innervation Humans Iodine Radioisotopes / diagnostic use Male Middle Aged Myocardial Infarction / pathology*, radionuclide imaging Myocardial Ischemia / pathology*, radionuclide imaging Myocardial Reperfusion Myocardium / pathology Risk Assessment Sympathetic Nervous System / blood supply*, pathology* Technetium Tc 99m Sestamibi / diagnostic use Tomography, Emission-Computed, Single-Photon |
| Chemical | |
Reg. No./Substance:
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0/Iodine Radioisotopes; 109581-73-9/Technetium Tc 99m Sestamibi; EC 2.7.3.2/Creatine Kinase |
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