碘-123间碘苄胍显像反映了充血性心力衰竭时强烈的心肌肾上腺素能神经活动，与潜在病因无关。

Iodine-123 metaiodobenzylguanidine images reflect intense myocardial adrenergic nervous activity in congestive heart failure independent of underlying cause.

作者信息

Imamura Y, Ando H, Mitsuoka W, Egashira S, Masaki H, Ashihara T, Fukuyama T

机构信息

Department of Cardiology, Matsuyama Red Cross Hospital, Japan.

出版信息

J Am Coll Cardiol. 1995 Dec;26(7):1594-9. doi: 10.1016/0735-1097(95)00374-6.

DOI:10.1016/0735-1097(95)00374-6

PMID:7594091

Abstract

OBJECTIVES

This study was undertaken to assess myocardial adrenergic activity using iodine-123 metaiodobenzylguanidine (MIBG) imaging in patients with heart failure.

BACKGROUND

In patients with congestive heart failure, adrenergic nerve activity is accelerated. However, whether myocardial adrenergic nerve activity reflects the severity of heart failure and its relation to the underlying cause have not yet been elucidated.

METHODS

Planar MIBG images were obtained from 96 patients with heart failure and compared with images from 9 age-matched healthy subjects. Groups 1 and 2 included 65 patients with heart failure related to impaired myocardial function and whose left ventricular ejection fraction was < 40% (group 1 = 40 patients with dilated cardiomyopathy; group 2 = 25 patients with ischemic cardiomyopathy). Group 3 included 31 patients with heart failure related to a mechanical abnormality and whose left ventricular ejection fraction was > 40% (mitral regurgitation in 16, aortic regurgitation in 9, aortic and mitral regurgitation in 4, ruptured aneurysm of Valsalva in 2). Myocardial uptake of MIBG was calculated as the heart/mediastinal activity ratio. Storage and release of MIBG were calculated as percent myocardial MIBG washout from 15 min to 4 h after isotope injection.

RESULTS

The heart/mediastinal activity ratio in the immediate images (15 min) showed a significant decrease only in patients with severe heart failure (groups 1 and 2). The myocardial washout was accelerated in all three heart failure groups. The level of myocardial washout was related to severity of heart failure and correlated well with New York Heart Association functional classification.

CONCLUSIONS

In severe heart failure associated with cardiomyopathy, norepinephrine uptake is reduced. In addition, myocardial adrenergic nerve activity is accelerated in proportion to severity of heart failure, independent of the underlying cause.

摘要

目的

本研究旨在利用碘 - 123间碘苄胍（MIBG）显像评估心力衰竭患者的心肌肾上腺素能活性。

背景

在充血性心力衰竭患者中，肾上腺素能神经活动加速。然而，心肌肾上腺素能神经活动是否反映心力衰竭的严重程度及其与潜在病因的关系尚未阐明。

方法

对96例心力衰竭患者进行平面MIBG显像，并与9例年龄匹配的健康受试者的图像进行比较。第1组和第2组包括65例因心肌功能受损导致心力衰竭且左心室射血分数<40%的患者（第1组 = 40例扩张型心肌病患者；第2组 = 25例缺血性心肌病患者）。第3组包括31例因机械异常导致心力衰竭且左心室射血分数>40%的患者（16例二尖瓣反流，9例主动脉瓣反流，4例主动脉瓣和二尖瓣反流，2例瓦氏窦瘤破裂）。MIBG的心肌摄取量计算为心脏/纵隔活性比值。MIBG的储存和释放计算为同位素注射后15分钟至4小时心肌MIBG清除率的百分比。