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心力衰竭中的 I-MIBG 成像:合并症对心脏交感神经支配的影响。

I-MIBG imaging in heart failure: impact of comorbidities on cardiac sympathetic innervation.

机构信息

Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

IRCCS Synlab SDN, Naples, Italy.

出版信息

Eur J Nucl Med Mol Imaging. 2023 Feb;50(3):813-824. doi: 10.1007/s00259-022-05941-3. Epub 2022 Sep 8.

Abstract

PURPOSE

Heart failure (HF) is a primary cause of morbidity and mortality worldwide, with significant impact on life quality and extensive healthcare costs. Assessment of myocardial sympathetic innervation function plays a central role in prognosis assessment in HF patients. The aim of this review is to summarize the most recent evidence regarding the clinical applications of iodine-123 metaiodobenzylguanidine (I-MIBG) imaging in patients with HF and related comorbidities.

METHODS

A comprehensive literature search was conducted on PubMed and Web of Science databases. Articles describing the impact of I-MIBG imaging on HF and related comorbidities were considered eligible for the review.

RESULTS

We collected several data reporting that I-MIBG imaging is a safe and non-invasive tool to evaluate dysfunction of cardiac sympathetic neuronal function and to assess risk stratification in HF patients. HF is frequently associated with comorbidities that may affect cardiac adrenergic innervation. Furthermore, HF is frequently associated with comorbidities and chronic conditions, such as diabetes, obesity, kidney disease and others, that may affect cardiac adrenergic innervation.

CONCLUSION

Comorbidities and chronic conditions lead to more severe impairment of sympathetic nervous system in patients with HF, with a negative impact on disease progression and outcome. Cardiac imaging with I-MIBG can be a useful tool to reduce morbidity and prevent adverse events in HF patients.

摘要

目的

心力衰竭(HF)是全球发病率和死亡率的主要原因,对生活质量和广泛的医疗保健成本有重大影响。评估心肌交感神经支配功能在 HF 患者的预后评估中起着核心作用。本综述的目的是总结关于碘-123 间碘苄胍(I-MIBG)成像在 HF 患者及相关合并症中的临床应用的最新证据。

方法

在 PubMed 和 Web of Science 数据库上进行了全面的文献检索。考虑将描述 I-MIBG 成像对 HF 和相关合并症影响的文章纳入本综述。

结果

我们收集了一些数据,这些数据表明 I-MIBG 成像作为一种安全且非侵入性的工具,可用于评估心脏交感神经功能障碍,并对 HF 患者进行风险分层。HF 常与可能影响心脏肾上腺素能神经支配的合并症相关。此外,HF 常与合并症和慢性疾病相关,如糖尿病、肥胖症、肾病等,这些疾病可能会影响心脏肾上腺素能神经支配。

结论

合并症和慢性疾病导致 HF 患者的交感神经系统损伤更加严重,对疾病进展和结局产生负面影响。I-MIBG 心脏成像可能是减少 HF 患者发病率和预防不良事件的有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e48f/9852124/4ddddbcc237c/259_2022_5941_Fig1_HTML.jpg

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