Ongoing myocardial damage relates to cardiac sympathetic nervous disintegrity in patients with heart failure.
Iodine-123-metaiodobenzylguanidine (123I-MIBG) has been used to assess the integrity and function of the cardiac sympathetic nervous system in patients with heart failure. Heart-type fatty acid binding protein (H-FABP) is released into the circulation when the myocardium is injured, and H-FABP has been recently used as a novel marker for the diagnosis of ongoing myocardial damage.


OBJECTIVE
The aim of the present study was to compare cardiac sympathetic nervous activity assessed by 123I-MIBG imaging with serum levels of H-FABP in patients with heart failure.


METHODS
Fifty patients with chronic heart failure were studied. 123I-MIBG imaging was carried out at 30 min (early) and 240 min (delayed) after the tracer injection. We measured serum levels of H-FABP using a sandwich enzyme linked immunosorbent assay.


RESULTS
Heart to mediastinum (H/M) ratios of 123I-MIBG decreased and washout rate increased with higher New York Heart Association (NYHA) functional class. H-FABP, norepinephrine and brain natriuretic peptide (BNP) levels increased as the severity of NYHA class advanced. Delayed H/M ratio was significantly correlated with H-FABP (r = -0.296, p = 0.029) and BNP (r = -0.335, p = 0.0213). Myocardial washout rate of 123I-MIBG was also correlated with H-FABP (r = 0.469, p < 0.001), norepinephrine (r = 0.433, p = 0.005), and BNP (r = 0.465, p = 0.001).


CONCLUSIONS
These data suggest that cardiac sympathetic nervous activation was associated with ongoing cardiomyocyte damage characterized by an elevated serum level of H-FABP in patients with heart failure. 123I-MIBG imaging is an appropriate approach to evaluate non-invasively not only cardiac sympathetic nervous activity, but also latent ongoing myocardial damage in the failing heart.
Arimoto
Takanori
T
First Department of Internal Medicine, Division of Radiology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan.
Takeishi
Yasuchika
Y
Niizeki
Takeshi
T
Koyama
Yo
Y
Okuyama
Hidenobu
H
Nozaki
Naoki
N
Hirono
Osamu
O
Tsunoda
Yuichi
Y
Miyashita
Takehiko
T
Shishido
Tetsuro
T
Okada
Akio
A
Takahashi
Kazuei
K
Kubota
Isao
I
D019797:3-Iodobenzylguanidine; D000368:Aged; D009202:Cardiomyopathies / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013223:Statistics as Topic; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging*
D050556:Fatty Acid-Binding Proteins; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine