title: Value of iodine-123 metaiodobenzylguanidine scintigraphy in patients with vasospastic angina.
abstract: To assess the presence and location of presynaptic myocardial sympathetic abnormality in patients with vasospastic angina, iodine-123 labelled metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET) was performed. Fifty patients suspected of having vasospastic angina pectoris were enrolled in the study. All patients underwent a provocative test with intracoronary ergonovine infusion during coronary angiography, in which 99%-100% obstructive spasm was defined as a positive result. Twenty-five patients were diagnosed as having vasospastic angina based on a positive provocative test. MIBG SPET was performed at 20 min and 3 h after administration of 111 MBq or MIBG. On early images, only 5 of 25 patients with vasospastic angina showed a mild reduction in MIBG uptake, whereas 3-h delayed images demonstrated MIBG abnormality in 20 patients (80%). The location of the MIBG abnormality was completely or partially consistent with the spastic coronary territory in 18 patients. On the other hand, only 4 of 25 patients (16%) with negative provocative test demonstrated reduced MIBG uptake. Accordingly, positive and negative predictive values of MIBG SPET for the provocative test were 83% (20/24) and 81% (21/26) respectively. In conclusion, MIBG scintigraphy with SPET can permit the non-invasive detection and evaluation of suspected vasospastic angina.
authors.affiliation: Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Taki
authors.forename: S
authors.initials: S
authors.lastname: Yasuhara
authors.forename: T
authors.initials: T
authors.lastname: Takamatsu
authors.forename: K
authors.initials: K
authors.lastname: Nakajima
authors.forename: R
authors.initials: R
authors.lastname: Tatami
authors.forename: S
authors.initials: S
authors.lastname: Ishise
authors.forename: I
authors.initials: I
authors.lastname: Matsunari
authors.forename: T
authors.initials: T
authors.lastname: Takayama
authors.forename: N
authors.initials: N
authors.lastname: Tonami
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine