Asghar O, Arumugam P, Armstrong I S, Ray S G, Schmitt M, Malik R A
Institute of Cardiovascular Sciences, University of Manchester & Manchester Heart Centre, Central Manchester Foundation Trust, Manchester, United Kingdom.
Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, United Kingdom.
J Nucl Cardiol. 2015 Dec;22(6):1262-8. doi: 10.1007/s12350-015-0070-2. Epub 2015 Feb 20.
Impaired glucose tolerance (IGT) is associated with an increased risk of type 2 diabetes (T2DM) and cardiovascular disease. Some but not all studies have reported cardiac autonomic dysfunction in subjects with IGT and there is only one direct study of cardiac innervation in subjects with IGT. The purpose of this study was to assess global and regional cardiac sympathetic innervation and cardiac autonomic function in individuals with IGT.
We undertook (123)I-mIBG scintigraphy and cardiac autonomic function in 15 subjects with IGT and 15 age and sex-matched healthy controls. Early heart to mediastinum ratio (HMR) (1.71 ± 0.17 vs 1.67 ± 0.13, P = .49), late HMR (1.73 ± 0.18 vs 1.73 ± 0.16, P = .97) and washout rate (WR) (18.6 ± 4.2 vs 19.1 ± 7.6%, P = .84), did not differ between subjects with IGT and control subjects. More detailed regional analysis revealed reduced tracer uptake at the apex, base and inferior wall in all subjects and the anterior wall in a minority of subjects. There were no differences in total score (56.6 ± 4.0 vs 53.3 ± 8.4, P = .193), modified score (48.5 ± 3.3 vs 46.2 ± 6.0, P = .215), anterior wall score (10.2 ± 1.3 vs 10.1 ± 1.6, P = .898), inferior wall score (8.9 ± 1.9 vs 7.7 ± 2.6, P = .163), basal score (18.7 ± 1.9 vs 18.2 ± 3.3, P = .636) and tests of cardiac autonomic function between the groups.
Global and regional measures of MIBG uptake and washout as well as cardiac autonomic function did not differ between subjects with IGT and healthy controls.
糖耐量受损（IGT）与2型糖尿病（T2DM）及心血管疾病风险增加相关。部分但并非所有研究报告了IGT患者存在心脏自主神经功能障碍，且仅有一项针对IGT患者心脏神经支配的直接研究。本研究旨在评估IGT个体的整体及局部心脏交感神经支配和心脏自主神经功能。
我们对15例IGT患者及15例年龄和性别匹配的健康对照者进行了（123）I - mIBG闪烁显像及心脏自主神经功能检测。早期心脏与纵隔比值（HMR）（1.71±0.17对1.67±0.13，P = 0.49）、晚期HMR（1.73±0.18对1.73±0.16，P = 0.97）及洗脱率（WR）（18.6±4.2对19.1±7.6%，P = 0.84）在IGT患者与对照者之间无差异。更详细地进行局部分析显示，所有受试者的心尖、心底及下壁以及少数受试者的前壁示踪剂摄取减少。两组之间的总分（56.6±4.0对53.3±8.4，P = 0.193）、修正分（48.5±3.3对46.2±6.0，P = 0.215）、前壁评分（10.2±1.3对10.1±1.6，P = 0.898）、下壁评分（8.9±1.9对7.7±2.6，P = 0.163）、基底评分（18.7±1.9对18.2±3.3，P = 0.636）及心脏自主神经功能测试均无差异。
IGT患者与健康对照者之间，MIBG摄取及洗脱的整体和局部指标以及心脏自主神经功能并无差异。
