Document Detail

Kinetics of 123I-MIBG after acute myocardial infarction and reperfusion therapy.
MedLine Citation:
PMID:  10452304     Owner:  NLM     Status:  MEDLINE    
Metaiodobenzylguanidine (MIBG) washout from the myocardium has been thought to reflect sympathetic nerve tone. After acute myocardial infarction, however, little is known about this parameter. The aim of this study was to determine the significance of cardiac washout after myocardial infarction and early reperfusion by investigating MIBG kinetics and correlating those kinetics to clinical parameters. METHODS: Sixty patients with acute myocardial infarction underwent planar MIBG and thallium imaging within 14 d of early reperfusion therapy. Global uptake and washout in myocardium, lungs and liver were calculated from early and delayed images. A regional analysis of myocardial kinetics in normal and infarcted myocardium and in an infarct border zone was also performed. Scintigraphic data were correlated with heart-rate variability as an electrophysiologic marker for autonomic tone and prevalence of arrhythmia in 52 patients. Heart-rate variability was described by time-domain indices from long-term electrocardiogram recordings. An age-matched normal control group for MIBG consisted of 10 individuals without heart disease. RESULTS: The infarct patients had preserved left-ventricular ejection fraction (LVEF) (56% +/- 17%). Although late myocardial uptake was expectedly lower in infarct patients compared with healthy volunteers (2.36 +/- 0.66 versus 2.80 +/- 0.55; P = 0.04), global myocardial MIBG washout was faster (11.6% +/- 7.9% versus 0.2% +/- 10.2%, respectively; P = 0.002). Lung and liver kinetics did not differ in patients and healthy volunteers. Global MIBG washout showed a weak but significant positive correlation with the baseline heart rate (r = 0.28, P = 0.03) and an inverse correlation with LVEF (r = -0.28, P = 0.04). Washout was faster in a subgroup of 8 patients with reduced heart-rate variability (16.5% +/- 9.9% versus 10.3% +/- 8.3%; P = 0.04). Regional analysis revealed similar degrees of enhanced MIBG washout for infarcted (low perfusion, low MIBG uptake) and remote myocardium (normal perfusion, high MIBG uptake), whereas the border zone (normal perfusion, low MIBG uptake) showed a nonsignificant trend toward higher washout. CONCLUSION: After myocardial infarction, changes in MIBG kinetics occur specifically in the myocardium, whereas kinetics in lung and liver remain unchanged. Even in patients with left-ventricular function preserved by reperfusion therapy, MIBG washout is abnormal and globally increased. Enhanced washout may reflect increased sympathetic nerve tone and represent increased catecholamine turnover or impaired reuptake in the subacute phase of myocardial infarction.
F M Bengel; P Barthel; I Matsunari; G Schmidt; M Schwaiger
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  40     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-09-02     Completed Date:  1999-09-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  904-10     Citation Subset:  IM    
Nuklearmedizinische Klinik und Poliklinik, Technische Universität München, Munich, Germany.
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MeSH Terms
3-Iodobenzylguanidine / diagnostic use,  pharmacokinetics*
Arrhythmias, Cardiac / diagnosis
Data Interpretation, Statistical
Electrocardiography, Ambulatory
Heart / radionuclide imaging*
Heart Rate
Iodine Radioisotopes / diagnostic use
Lung / metabolism,  radionuclide imaging
Middle Aged
Models, Cardiovascular
Myocardial Infarction / physiopathology,  radionuclide imaging*,  therapy
Myocardial Reperfusion*
Myocardium / metabolism*
Radiopharmaceuticals / diagnostic use,  pharmacokinetics*
Thallium Radioisotopes / diagnostic use
Time Factors
Reg. No./Substance:
0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 77679-27-7/3-Iodobenzylguanidine

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