Takeishi Y, Sukekawa H, Sakurai T, Saito H, Nishimura S, Shibu T, Sasaki Y, Tomoike H
Division of Cardiology, Ishinomaki Red Cross Hospital, Japan.
Ann Nucl Med. 1994 Aug;8(3):177-82. doi: 10.1007/BF03164994.
To test the feasibility of myocardial 123I-MIBG and 123I-BMIPP imaging for the early detection of anthracycline cardiotoxicity, 13 patients who had received anthracycline anticancer chemotherapeutic agents were studied. Two-dimensional echocardiography and myocardial imaging with both 123I-MIBG and 123I-BMIPP were performed in 13 patients treated with anthracycline (group A) and 10 normal control subjects (group C). Anterior myocardial images were obtained 15 minutes and 3 hours after the injection of isotopes. The heart-to-mediastinum ratio (H/M ratio) was used to quantify cardiac 123I-MIBG and 123I-BMIPP uptake. The left ventricular shortening fraction (%SF) and the ratio of peak mitral flow velocity in early diastole to that at the time of atrial systole (E/A ratio) were measured by echocardiography. The H/M ratio of 123I-MIBG was lower in group A than in group C (1.5 +/- 0.2 vs. 1.9 +/- 0.2, p < 0.01). The patients in group A had faster clearance of 123I-MIBG from the myocardium than those in group C (27 +/- 10% vs. 22 +/- 4%, p < 0.05). However, the H/M ratio and clearance of 123I-BMIPP were similar between the two groups (H/M ratio: 2.1 +/- 0.2 vs. 2.0 +/- 0.2, clearance: 24 +/- 6% vs. 26 +/- 6%). The %SF (37 +/- 8% vs. 36 +/- 7%) and E/A ratio (1.4 +/- 0.4 vs. 1.6 +/- 0.3) were comparable in groups A and C. The present findings indicated that myocardial imaging with 123I-MIBG could detect myocardial damage in patients treated with anthracycline in the early stage when cardiac systolic and diastolic function was still preserved. Early detection of anthracycline cardiotoxicity by 123I-MIBG would reduce the incidence and severity of heart failure.
为了测试心肌123I - MIBG和123I - BMIPP显像用于早期检测蒽环类药物心脏毒性的可行性，对13例接受蒽环类抗癌化疗药物治疗的患者进行了研究。对13例接受蒽环类药物治疗的患者（A组）和10名正常对照者（C组）进行了二维超声心动图检查以及123I - MIBG和123I - BMIPP心肌显像。在注射同位素后15分钟和3小时获取前壁心肌图像。用心脏与纵隔比值（H/M比值）对心脏摄取123I - MIBG和123I - BMIPP进行定量分析。通过超声心动图测量左心室缩短分数（%SF）以及舒张早期二尖瓣血流峰值速度与心房收缩期时二尖瓣血流峰值速度之比（E/A比值）。A组123I - MIBG的H/M比值低于C组（1.5±0.2对1.9±0.2，p<0.01）。A组患者心肌中123I - MIBG的清除速度比C组患者快（27±10%对22±4%，p<0.05）。然而，两组之间123I - BMIPP的H/M比值和清除率相似（H/M比值：2.1±0.2对2.0±0.2，清除率：24±6%对26±6%）。A组和C组的%SF（37±8%对36±7%）和E/A比值（1.4±0.4对1.6±0.3）具有可比性。目前的研究结果表明，在心脏收缩和舒张功能仍保留的早期阶段，123I - MIBG心肌显像能够检测出接受蒽环类药物治疗患者的心肌损伤。通过123I - MIBG早期检测蒽环类药物心脏毒性将降低心力衰竭的发生率和严重程度。
