Evidence for regional catecholamine uptake and storage sites in the transplanted human heart by positron emission tomography.
Positron emission tomography in combination with the newly introduced catecholamine analogue [11C]hydroxyephedrine ([11C]HED) enables the noninvasive delineation of sympathetic nerve terminals of the heart. To address the ongoing controversy over possible reinnervation of the human transplant, 5 healthy control subjects and 11 patients were studied after cardiac transplant by this imaging approach. Regional [11C]HED retention was compared to regional blood flow as assessed by rubidium-82. Transplant patients were divided into two groups. Group I had recent (less than 1 yr, 4.4 +/- 2.3 mo) surgery, while group II patients underwent cardiac transplantation more than 2 yr before imaging (3.5 +/- 1.3 yr). [11C]HED retention paralleled blood flow in normals, but was homogeneously reduced in group I. In contrast, group II patients revealed heterogeneous [11C]HED retention, with increased uptake in the proximal anterior and septal wall. Quantitative evaluation of [11C]HED retention revealed a 70% reduction in group I and 59% reduction in group II patients (P less than 0.001). In group II patients, [11C]HED retention reached 60% of normal in the proximal anterior wall. These data suggest the presence of neuronal tissue in the transplanted human heart, which may reflect regional sympathetic reinnervation.
Schwaiger
M
M
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0028.
Hutchins
G D
GD
Kalff
V
V
Rosenspire
K
K
Haka
M S
MS
Mallette
S
S
Deeb
G M
GM
Abrams
G D
GD
Wieland
D
D
D001794:Blood Pressure / Q000187:drug effects; D002250:Carbon Radioisotopes; D002395:Catecholamines / Q000378:metabolism*; D004809:Ephedrine / Q000031:analogs & derivatives* / Q000494:pharmacology; D006321:Heart / Q000294:innervation*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D013564:Sympathetic Nervous System / Q000378:metabolism; D014055:Tomography, Emission-Computed
D002250:Carbon Radioisotopes; D002395:Catecholamines; C065363:3-hydroxyephedrine; D004809:Ephedrine