Tsukamoto Takahiro, Morita Koichi, Naya Masanao, Inubushi Masayuki, Katoh Chietsugu, Nishijima Kenichi, Kuge Yuji, Okamoto Hiroshi, Tsutsui Hiroyuki, Tamaki Nagara
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Nucl Med. 2007 Nov;48(11):1777-82. doi: 10.2967/jnumed.107.043794. Epub 2007 Oct 17.
Cardiac sympathetic function plays an important role in the regulation of left ventricular (LV) function and the pathophysiology of LV dysfunction. (11)C-CGP-12177 ((11)C-CGP) has been used to assess myocardial beta-adrenergic receptor (beta-AR) density in vivo using PET. The aim of this study is to measure myocardial beta-AR density in patients with nonischemic cardiomyopathy and to compare the measurements with various standard parameters of heart failure (HF), particularly with presynaptic function assessed by (123)I- metaiodobenzylguanidine ((123)I-MIBG) imaging.
(11)C-CGP PET was performed on 16 patients with nonischemic cardiomyopathy and 8 age-matched healthy volunteers using a double injection method. A (11)C-CGP dynamic scan for 75 min was performed after the injection of (11)C-CGP with a high specific activity. After 30 min, (11)C-CGP with a low specific activity was injected. The beta-AR density of the whole LV was calculated on the basis of the graphical analysis method. Additionally, beta-AR density was compared with LV ejection fraction (LVEF), sympathetic presynaptic function assessed using (123)I-MIBG kinetics, and neurohormonal parameters.
The beta-AR density of patients was significantly lower than that of healthy volunteers (3.80 +/- 0.96 vs. 7.70 +/- 1.92 pmol/mL; P < 0.0001). In the patients, beta-AR density correlated significantly with LVEF (r = 0.62, P < 0.05). Furthermore, beta-AR density correlated significantly with the (123)I-MIBG washout rate (r = -0.68, P < 0.01) and delayed heart-to-mediastinum ratio (H/M ratio) (r = 0.61, P < 0.05). On the other hand, the correlation between beta-AR density and early H/M ratio was not significant (r = 0.40, P = 0.13). The beta-AR density of patients with severe HF (New York Heart Association functional [NYHA] class III) was significantly lower than that of those with NYHA functional class I or class II HF (3.24 +/- 0.96 vs. 4.24 +/- 0.73 pmol/mL; P < 0.05).
A reduction in beta-AR density measured by (11)C-CGP PET was observed in patients with nonischemic cardiomyopathy. This downregulation may be due to the increased presynaptic sympathetic tone as assessed by (123)I-MIBG imaging.
心脏交感神经功能在左心室（LV）功能调节及LV功能障碍的病理生理学中起重要作用。（11）C - CGP - 12177（（11）C - CGP）已被用于通过PET在体内评估心肌β - 肾上腺素能受体（β - AR）密度。本研究的目的是测量非缺血性心肌病患者的心肌β - AR密度，并将测量结果与心力衰竭（HF）的各种标准参数进行比较，特别是与通过（123）I - 间碘苄胍（（123）I - MIBG）成像评估的突触前功能进行比较。
使用双注射法对16例非缺血性心肌病患者和8名年龄匹配的健康志愿者进行（11）C - CGP PET检查。在注射高比活度的（11）C - CGP后进行75分钟的（11）C - CGP动态扫描。30分钟后，注射低比活度的（11）C - CGP。基于图形分析法计算整个左心室的β - AR密度。此外，将β - AR密度与左心室射血分数（LVEF）、使用（123）I - MIBG动力学评估的交感神经突触前功能以及神经激素参数进行比较。
患者的β - AR密度显著低于健康志愿者（3.80±0.96对7.70±1.92 pmol/mL；P < 0.0001）。在患者中，β - AR密度与LVEF显著相关（r = 0.62，P < 0.05）。此外，β - AR密度与（123）I - MIBG洗脱率（r = -0.68，P < 0.01）和延迟的心/纵隔比（H/M比）（r = 0.61，P < 0.05）显著相关。另一方面，β - AR密度与早期H/M比之间的相关性不显著（r = 0.40，P = 0.13）。重度HF（纽约心脏协会功能[NYHA] III级）患者的β - AR密度显著低于NYHA功能I级或II级HF患者（3.24±0.96对4.24±0.73 pmol/mL；P < 0.05）。
在非缺血性心肌病患者中观察到通过（11）C - CGP PET测量的β - AR密度降低。这种下调可能是由于通过（123）I - MIBG成像评估的突触前交感神经张力增加所致。
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