Naruse H, Arii T, Kondo T, Ohnishi M, Sakaki T, Takahashi K, Masai M, Ohyanagi M, Iwasaki T, Fukuchi M
First Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Ann Nucl Med. 2000 Dec;14(6):427-32. doi: 10.1007/BF02988288.
It is likely that a close association exists between findings obtained by two methods: dobutamine stress echocardiography and 123I-MIBG scintigraphy. Both of these methods are associated with beta-adrenergic receptor mechanisms. This study was conducted to demonstrate the relation between myocardial response to dobutamine stress and sympathetic nerve release of norepinephrine in the failing heart. In 12 patients with heart failure due to idiopathic dilated cardiomyopathy, the myocardial effects of dobutamine stress were evaluated by low-dose dobutamine stress echocardiography: and sympathetic nerve function was evaluated by scintigraphic imaging with iodine-123 [123I] meta-iodobenzylguanidine (MIBG), an analogue of norepinephrine. Echocardiography provided quantitative assessment of wall motion and left ventricular dilation; radiotracer studies with 123I-MIBG provided quantitative assessment of the heart-to-mediastinum (H/M) uptake ratio and washout rate. Results showed that H/M correlated with baseline wall motion (r = 0.682, p = 0.0146), wall motion after dobutamine stress (r = 0.758, p = 0.0043), the change in wall motion (r = 0.667, p = 0.0178), and with left ventricular diastolic diameter (r = 0.837, p = 0.0007). In addition, the 123I-MIBG washout rate correlated with baseline wall motion (r = 0.608, p = 0.0360), wall motion after dobutamine stress (r = 0.703, p = 0.0107), and with the change in wall motion (r = 0.664, p = 0.0185). Wall motion, especially in the myocardial response to dobutamine stress, is related to sympathetic nerve activity in heart failure.
多巴酚丁胺负荷超声心动图和123I - MIBG闪烁显像。这两种方法均与β - 肾上腺素能受体机制相关。本研究旨在证明在衰竭心脏中，心肌对多巴酚丁胺负荷的反应与去甲肾上腺素的交感神经释放之间的关系。在12例因特发性扩张型心肌病导致心力衰竭的患者中，通过低剂量多巴酚丁胺负荷超声心动图评估多巴酚丁胺负荷的心肌效应；并通过使用去甲肾上腺素类似物碘 - 123 [123I]间碘苄胍（MIBG）的闪烁显像评估交感神经功能。超声心动图提供了室壁运动和左心室扩张的定量评估；123I - MIBG放射性示踪剂研究提供了心脏与纵隔（H/M）摄取率和洗脱率的定量评估。结果显示，H/M与基线室壁运动相关（r = 0.682，p = 0.0146）、多巴酚丁胺负荷后的室壁运动相关（r = 0.758，p = 0.0043）、室壁运动的变化相关（r = 0.667，p = 0.0178），以及与左心室舒张直径相关（r = 0.837，p = 0.0007）。此外，123I - MIBG洗脱率与基线室壁运动相关（r = 0.608，p = 0.0360）、多巴酚丁胺负荷后的室壁运动相关（r = 0.703，p = 0.0107），以及与室壁运动的变化相关（r = 0.664，p = 0.0185）。室壁运动，尤其是在心肌对多巴酚丁胺负荷的反应中，与心力衰竭中的交感神经活动相关。
