title: Evaluation of cardiac sympathetic neuronal integrity in diabetic patients using iodine-123 metaiodobenzylguanidine.
abstract: Autonomic dysfunction is associated with increased mortality in diabetic patients. To evaluate the cardiac autonomic dysfunction in these patients, a prospective study was undertaken using iodine-123 metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET). The study groups consisted of ten diabetic patients with cardiac autonomic neuropathy (group I) and six without autonomic neuropathy (group II). Autonomic nervous function tests, thallium scan, radionuclide ventriculographic data including ejection fraction and wall motion study, and 24-h urine catecholamine levels were evaluated. 123I-MIBG SPET was performed at 30 min and 4h following injection of 3 mCi of 123I-MIBG in groups I and II and in normal subjects (n=4). On planar images, the heart to mediastinum (H/M) ratio was measured. Defect pattern and severity of MIBG uptake were qualitatively analysed on SPET. Compared with control subjects, diabetic patients had a reduced H/M ratio regardless of the presence of clinical autonomic neuropathy. There was no difference in H/M ratio between groups I and II. On SPET images, focal or diffuse defects were demonstrated in all patients in group I, and in five of the six patients in group II. The extent of defects tended to be more pronounced in group I than in group II. In conclusion, 123I-MIBG scan was found to be a more sensitive method than clinical autonomic nervous function tests for the detection of autonomic neuropathy in diabetes.
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, Yonsei University, College of Medicine, 134 Shincheon-dong, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Kim
authors.forename: J D
authors.initials: JD
authors.lastname: Lee
authors.forename: Y H
authors.initials: YH
authors.lastname: Ryu
authors.forename: P
authors.initials: P
authors.lastname: Jeon
authors.forename: Y W
authors.initials: YW
authors.lastname: Shim
authors.forename: H S
authors.initials: HS
authors.lastname: Yoo
authors.forename: C Y
authors.initials: CY
authors.lastname: Park
authors.forename: S G
authors.initials: SG
authors.lastname: Lim
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000000981:diagnostic imaging*; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging*; D004837:Epinephrine / Q000652:urine; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000652:urine; D013564:Sympathetic Nervous System / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019797:3-Iodobenzylguanidine; D009638:Norepinephrine; D004837:Epinephrine