Noninvasive detection of cardiac sympathetic nervous dysfunction in diabetic patients using [123I]metaiodobenzylguanidine.
The association between clinical autonomic dysfunction and myocardial MIBG accumulation was investigated. The study groups comprised 6 male diabetic patients with autonomic neuropathy (ANP+ group), 6 male diabetic patients without autonomic neuropathy (ANP-group), and 6 male nondiabetic control subjects. The mean age was comparable in all groups, and the subjects had no evidence of coronary heart disease. Reduced heart-rate variation in a deep-breathing test was used as a criterion for autonomic neuropathy. Immediately after injection, the peak net influx rate of MIBG to myocardium was significantly (P less than 0.05) reduced in both diabetic groups. At 6 hr after MIBG injection, the MIBG uptake of the myocardium was significantly (P less than 0.05) smaller in the ANP+ group than in the control group. In the ANP- group, the MIBG uptake of the myocardium was between that of the ANP+ group and that of the control group. Our data show that reduced myocardial MIBG accumulation is associated with autonomic dysfunction in diabetic patients, but it can occur to a lesser extent also in diabetic patients without apparent autonomic neuropathy. The measurement of the myocardial MIBG accumulation is a promising new method to detect cardiac sympathetic nervous dysfunction in diabetic patients.
Mäntysaari
M
M
Department of Clinical Physiology, Kuopio University Hospital, Finland.
Kuikka
J
J
Mustonen
J
J
Tahvanainen
K
K
Vanninen
E
E
Länsimies
E
E
Uusitupa
M
M
D019797:3-Iodobenzylguanidine; D001341:Autonomic Nervous System / Q000502:physiology; D002395:Catecholamines / Q000097:blood; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007275:Injections, Intravenous; D007457:Iodine Radioisotopes; D007462:Iodobenzenes / Q000008:administration & dosage / Q000032:analysis; D007537:Isometric Contraction / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry / Q000378:metabolism; D013564:Sympathetic Nervous System / Q000502:physiology*; D013565:Sympatholytics / Q000008:administration & dosage / Q000032:analysis
D002395:Catecholamines; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013565:Sympatholytics; D019797:3-Iodobenzylguanidine