Higo Kenjuro, Kubota Kayoko, Miyanaga Sunao, Miyata Masaaki, Nakajo Masatoyo, Jinguji Megumi, Ohishi Mitsuru
Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University.
Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University.
Int Heart J. 2018 Jan 27;59(1):112-119. doi: 10.1536/ihj.16-629. Epub 2018 Jan 15.
According to recent studies, lung uptake of iodine-123-metaiodobenzylguanidine (I-MIBG) is impaired in many lung diseases and low lung uptake of I-MIBG suggests endothelial dysfunction of the pulmonary artery. I-MIBG scintigraphy in patients with pulmonary hypertension (PH) has not yet been clinically evaluated. We hypothesized that the lung uptake of I-MIBG is reduced in patients with PH and differs among PH subtypes. The purpose of the present study was to analyze the lung uptake of I-MIBG in patients with PH and compare it with the data obtained by echocardiography or right heart catheterization. I-MIBG scintigraphy was performed in 286 consecutive patients from 2003 to 2014. We enrolled 21 patients with PH and 8 control patients. The 21 patients with PH were categorized into those with pulmonary artery hypertension (PAH, n = 12) and those with chronic thromboembolic pulmonary hypertension (CTEPH, n = 9). The mean pulmonary artery pressure was not significantly different between patients with CTEPH and PAH (37.7 ± 6.8 versus 32.3 ± 5.3 mmHg respectively; P = 0.054). There were no significant differences in any other hemodynamic parameters between the two groups. The lung uptake of I-MIBG in PAH patients (early image: 1.54 ± 0.18, delayed image: 1.41 ± 0.16) was significantly lower than that of CTEPH patients (early image: 2.17 ± 0.25, P < 0.0001; delayed image: 1.99 ± 0.20, P = 0.0001, adjusted for age and World Health Organization classification) and controls (early image: 2.32 ± 0.27, P = 0.0007; delayed image: 1.92 ± 0.19, P = 0.0007). In conclusion, we found for the first time that the lung uptake of I-MIBG in patients with PAH is lower than that in patients with CTEPH and controls.
根据最近的研究，许多肺部疾病患者的肺对碘-123-间碘苄胍（I-MIBG）的摄取受损，而I-MIBG肺摄取量低提示肺动脉内皮功能障碍。肺动脉高压（PH）患者的I-MIBG闪烁扫描尚未进行临床评估。我们推测PH患者的I-MIBG肺摄取量降低，且在PH亚型之间存在差异。本研究的目的是分析PH患者的I-MIBG肺摄取情况，并将其与通过超声心动图或右心导管检查获得的数据进行比较。2003年至2014年对286例连续患者进行了I-MIBG闪烁扫描。我们纳入了21例PH患者和8例对照患者。21例PH患者被分为肺动脉高压（PAH，n = 12）患者和慢性血栓栓塞性肺动脉高压（CTEPH，n = 9）患者。CTEPH患者和PAH患者的平均肺动脉压无显著差异（分别为37.7±6.8 mmHg和32.3±5.3 mmHg；P = 0.054）。两组之间的任何其他血流动力学参数均无显著差异。PAH患者的I-MIBG肺摄取量（早期图像：1.54±0.18，延迟图像：1.41±0.16）显著低于CTEPH患者（早期图像：2.17±0.25，P < 0.0001；延迟图像：1.99±0.20，P = 0.0001，根据年龄和世界卫生组织分类进行调整）和对照患者（早期图像：2.32±0.27，P = 0.0007；延迟图像：1.92±0.19，P = 0.0007）。总之，我们首次发现PAH患者的I-MIBG肺摄取量低于CTEPH患者和对照患者。
