Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands.
J Nucl Cardiol. 2022 Dec;29(6):3341-3351. doi: 10.1007/s12350-022-02951-4. Epub 2022 Apr 4.
In patients with heart failure (HF) sequential imaging studies have demonstrated a relationship between myocardial perfusion and adrenergic innervation. We evaluated the feasibility of a simultaneous low-dose dual-isotope I/Tc-acquisition protocol using a cadmium-zinc-telluride (CZT) single-photon emission computed tomography (SPECT) camera.
Thirty-six patients with HF underwent simultaneous low-dose I-metaiodobenzylguanidine (MIBG)/Tc-sestamibi gated CZT-SPECT cardiac imaging. Perfusion and innervation total defect sizes and perfusion/innervation mismatch size (defined by I-MIBG defect size minus Tc-sestamibi defect size) were expressed as percentages of the total left ventricular (LV) surface area. LV ejection fraction (EF) significantly correlated with perfusion defect size (P < .005), innervation defect size (P < .005), and early (P < .05) and late (P < .01) I-MIBG heart-to-mediastinum (H/M) ratio. In addition, late H/M ratio was independently associated with reduced LVEF (P < .05). Although there was a significant relationship (P < .001) between perfusion and innervation defect size, innervation defect size was larger than perfusion defect size (P < .001). At multivariable linear regression analysis, I-MIBG washout rate (WR) correlated with perfusion/innervation mismatch (P < .05).
In patients with HF, a simultaneous low-dose dual-isotope I/Tc-acquisition protocol is feasible and could have important clinical implications.
在心力衰竭（HF）患者中，连续影像学研究已经证明了心肌灌注和肾上腺素能神经支配之间存在关系。我们评估了使用碲化镉锌（CZT）单光子发射计算机断层扫描（SPECT）相机进行同时低剂量双同位素 I/Tc 采集方案的可行性。
36 例 HF 患者接受了同时进行的低剂量 I-间碘苄胍（MIBG）/Tc-甲氧基异丁基异腈门控 CZT-SPECT 心脏成像。灌注和神经支配总缺陷大小以及灌注/神经支配不匹配大小（定义为 I-MIBG 缺陷大小减去 Tc-甲氧基异丁基异腈缺陷大小）表示为左心室（LV）总表面积的百分比。LV 射血分数（EF）与灌注缺陷大小显著相关（P < .005）、神经支配缺陷大小（P < .005）、早期（P < .05）和晚期（P < .01）I-MIBG 心/纵隔（H/M）比。此外，晚期 H/M 比与降低的 LVEF 独立相关（P < .05）。尽管灌注和神经支配缺陷大小之间存在显著关系（P < .001），但神经支配缺陷大小大于灌注缺陷大小（P < .001）。在多变量线性回归分析中，I-MIBG 洗脱率（WR）与灌注/神经支配不匹配相关（P < .05）。
在 HF 患者中，同时进行低剂量双同位素 I/Tc 采集方案是可行的，可能具有重要的临床意义。
