Noninvasive identification of anthracycline cardiotoxicity: comparison of 123I-MIBG and 123I-BMIPP imaging.
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.
Takeishi
Y
Y
Division of Cardiology, Ishinomaki Red Cross Hospital, Japan.
Sukekawa
H
H
Sakurai
T
T
Saito
H
H
Nishimura
S
S
Shibu
T
T
Sasaki
Y
Y
Tomoike
H
H
D019797:3-Iodobenzylguanidine; D015250:Aclarubicin / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D003630:Daunorubicin / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D004452:Echocardiography; D005227:Fatty Acids; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D011877:Radionuclide Imaging
D000903:Antibiotics, Antineoplastic; D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; C049338:iodofiltic acid; D019797:3-Iodobenzylguanidine; D015250:Aclarubicin; D004317:Doxorubicin; D003630:Daunorubicin