title: Regional sympathetic denervation detected by iodine 123 metaiodobenzylguanidine in non-Q-wave myocardial infarction and unstable angina.
abstract: Previous studies have revealed that the sympathetic nervous system is more vulnerable to ischemia than the myocardium itself. Thus our study was undertaken to detect denervated myocardium in non-Q-wave myocardial infarction (MI) and unstable angina with iodine 123 metaiodobenzylguanidine (123I-MIBG), which can delineate myocardial sympathetic innervation. Eight patients with non-Q-wave MI and 12 with unstable angina were studied. Sequential 123I-MIBG and thallium-201 chloride (201TlCl) imaging and single-photon emission computed tomography (SPECT) were performed at rest 24 +/- 12 days after the last ischemic attack. Myocardial perfusion defect was not detected by 201TlCl in 4 of 8 patients with non-Q-wave MI, whereas 123I-MIBG SPECT imaging revealed defects corresponding to myocardial ischemic areas predicted by coronary angiography in all 8 patients. 123I-MIBG imaging revealed defects in 7 of 12 patients with unstable angina corresponding to coronary angiographic findings, whereas no myocardial perfusion defect was detected by 201TlCl imaging in any of them. In conclusion, 123I-MIBG SPECT is a sensitive method for detecting myocardium exposed to transient ischemia that cannot be detected by 201TlCl imaging.
authors.affiliation: Department of Cardiology, School of Medicine, Tokai University, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tomoda
authors.forename: K
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Y
authors.initials: Y
authors.lastname: Shiina
authors.forename: R
authors.initials: R
authors.lastname: Tagawa
authors.forename: M
authors.initials: M
authors.lastname: Ide
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D011877:Radionuclide Imaging; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D003287:Contrast Media; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019797:3-Iodobenzylguanidine