A radiological analysis of heart sympathetic functions with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failure.
Cardiac scintigraphy with meta-[123I]iodobenzylguanidine (MIBG) is used to assess cardiac sympathetic function. We performed [123I]MIBG scintigraphy in 7 patients with neurological diseases presenting orthostatic hypotension and other autonomic failures (AF), 22 neurological patients without AF, and 9 healthy subjects. Thallium scintigraphy and echocardiography were also performed in all subjects. In this series, patients with any evidence of cardiac dysfunction were excluded. No [123I]MIBG accumulation was observed in all patients with AF, and cardiac defects were noted in 7 patients (5 with Parkinson's disease [PD], 2 with spinocerebellar degenerations [SCD]), and in some patients without AF. In contrast, the distribution of [123I]MIBG was normal in all the healthy subjects. No decrease in [123I]MIBG accumulation was resulted from drug therapy (droxidopa, amezinium and thyrotropin-releasing hormone). In conclusion, reduced accumulation on [123I]MIBG scintigraphy may be due to myocardial beta-adrenoceptor dysfunction or reduced central sympathetic activity of the heart, or both.
Department of Neurology, Nagoya Daini Red Cross Hospital, Japan.
S
S
Hakusui
T
T
Yasuda
T
T
Yanagi
J
J
Tohyama
Y
Y
Hasegawa
Y
Y
Koike
M
M
Hirayama
A
A
Takahashi
D019797:3-Iodobenzylguanidine; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000000981:diagnostic imaging / Q000503:physiopathology; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D009638:Norepinephrine / Q000378:metabolism; D011877:Radionuclide Imaging; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging* / Q000187:drug effects; D013565:Sympatholytics; D013793:Thallium
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013565:Sympatholytics; D019797:3-Iodobenzylguanidine; D013793:Thallium; D009638:Norepinephrine