Cardiac sympathetic imaging with mIBG in cirrhosis and portal hypertension: relation to autonomic and cardiac function

2012 ◽  
Vol 303 (11) ◽  
pp. G1228-G1235 ◽  
Author(s):  
Søren Møller ◽  
Christian Mortensen ◽  
Flemming Bendtsen ◽  
Lars T. Jensen ◽  
Jens P. Gøtze ◽  
...  
Keyword(s):  
Cardiac Dysfunction ◽  
Nervous Activity ◽  
Alcoholic Cirrhosis ◽  
Washout Rate ◽  
Sympathetic Nervous Activity ◽  
Catecholamine Level ◽  
Mibg Scintigraphy ◽  
Neuronal Function ◽  
Sympathetic Nervous

Autonomic and cardiac dysfunction is frequent in cirrhosis and includes increased sympathetic nervous activity, impaired heart rate variability (HRV), and baroreflex sensitivity (BRS). Quantified 123I-metaiodobenzylguanidine ( mIBG) scintigraphy reflects cardiac noradrenaline uptake, and in patients with cardiac failure it predicts outcome. In this study, we aimed to investigate cardiac sympathetic neuronal function in cirrhosis by mIBG scintigraphy in relation to cardiovascular function. Ten patients with alcoholic cirrhosis and 10 age- and sex-matched healthy controls participated in the study. Heart/mediastinum (H/M) ratios of mIBG uptake were calculated 15 and 230 min after intravenous injection of mIBG. Furthermore, washout rate (WOR) of mIBG was calculated. The patients underwent a liver vein catheterization with determination of splanchnic and systemic hemodynamics and measurement of HRV and BRS. mIBG-scintigraphy revealed significantly increased WOR in patients with cirrhosis compared with controls ( P < 0.005), whereas H/M uptakes were equal in the groups. Forty percent of the patients had reduced uptake of mIBG in the infero-lateral segment of the left ventricle. WOR correlated significantly with central circulation time, an estimate of central hypovolemia ( r = −0.64, P < 0.05) and frequency-corrected QTF interval ( r = 0.71, P = 0.01). Patients with cirrhosis had significantly decreased HRV and BRS correlating with indicators of abnormal cathecholamine uptake by mIBG although the catecholamine level was normal in the patients. In conclusion, in alcoholic cirrhosis, mIBG scintigraphy reveals autonomic dysfunction and impaired myocardial distribution of sympathetic nervous activity. It is associated to indicators of central hypovolemia, QT interval, and decreased HRV and BRS. Measurement of myocardial catecholamine uptake by mIBG may add important information on autonomic and cardiac dysfunction in cirrhosis.

scholarly journals Prognosis of atrial fibrillation radiofrequency ablation: Iodine-123-MIBG cardiac innervation imaging

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
Y Varlamova ◽  
K Zavadovsky ◽  
I Kisteneva ◽  
S Sazonova ◽  
R Batalov
Keyword(s):  
Atrial Fibrillation ◽  
Prognostic Value ◽  
Nervous Activity ◽  
Washout Rate ◽  
Mibg Scintigraphy ◽  
Coronary Syndrome ◽  
Sympathetic Nervous ◽  
99Mtc Mibi ◽  
Af Recurrence

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Russian Science Foundation BACKGROUND To date, radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is a valuable treatment option. So far there are no clear predictors of the effectiveness of AF ablation. Nowadays, the association of cardiac sympathetic nervous system and the development and maintenance of AF has been showed. The association between сardiac sympathetic system impairment, assessed by 123I-MIBG scintigraphy and RFCA effectiveness was shown previously. However, the is lack of data concerning to prognostic value of MIBG scintigraphy in patients with different forms of AF – persistent (PAF) and long-standing persistent (LSPAF). PURPOSE To study the prognostic significance of 123I-MIBG scintigraphy in RFCA efficacy in patients with persistent and long-standing persistent AF. METHODS The study enrolled 36 patients with drug-resistant AF (both persistent (n = 20) and long-standing persistent (n = 16) forms).  All patients had comorbidity as chronic coronary syndrome and hypertension. A comparison group (n = 10) was also enrolled in the study. It includes patients with chronic coronary syndrome and arterial hypertension (without arrhythmia). All patients underwent 123I-MIBG and 99mTc-MIBI scintigraphy to evaluate the cardiac sympathetic activity and myocardial perfusion, respectively. Patients with AF performed RFCA. After of 1 year follow-up patients were examined for AF recurrence. The AF recurrence was considered to be an AF of at least 30 sec duration on a 12-lead ECG or on the Holter monitoring. RESULTS During the follow-up period, AF recurrences were reported in 7 (35%) PAF patients and in 8 (50%) LSPAF patients. According to multivariate analysis only a high pre-ablation washout rate of 123I-MIBG (WR) in PAF patients (OR: 1.668; 95% CI: 1.093–2.548) and large pre-ablation 123I-MIBG/99mTc-MIBI mismatch score in LSPAF patients (OR: 2.155; 95% CI: 1.192–3.897) were independent predictors of AF recurrence after RFCA. ROC analysis indicated that in PAF patients with higher WR ≥ 20.8% (AUC: 0.968; Sensitivity: 100 %; Specificity: 45%; p &lt; 0.05) and LSPAF patients with larger 123I-MIBG/99mTc-MIBI mismatch score ≥ 12.5 % (AUC: 0.942; Sensitivity: 81 %; Specificity: 28 %; p &lt; 0.05) had a higher risk of AF recurrence after RFCA. CONCLUSION In AF patients the incidence of arrhythmia recurrence after RFCA is associated with impaired cardiac sympathetic nervous activity. In PAF patients the values of 123I-MIBG washout rate can predict AF recurrence. In LSPAF patients innervation/perfusion mismatch has prognostic value in terms of AF recurrence.

scholarly journals Renal 123I-MIBG Uptake before and after Live-Donor Kidney Transplantation

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 802
Author(s):  
Thomas Rasmussen ◽  
Robin de Nijs ◽  
Lene Kjær Olsen ◽  
Anne-Lise Kamper ◽  
Lia Evi Bang ◽  
...  
Keyword(s):  
Sympathetic Activity ◽  
Nervous Activity ◽  
Sympathetic Nervous Activity ◽  
Mibg Scintigraphy ◽  
Mibg Uptake ◽  
Post Transplantation ◽  
Donor Kidney ◽  
Sympathetic Nervous ◽  
Donor Kidney Transplantation ◽  
Renal Sympathetic

Increased sympathetic activity is suggested to be part of the pathogenesis in several diseases. Methods to evaluate sympathetic activity and renal nervous denervation procedural success are lacking. Scintigraphy using the norepinephrine analog Iodine-123 Metaiodobenzylguanidine (123I-MIBG) might provide information on renal sympathetic nervous activity. Renal transplantation induces complete denervation of the kidney and as such represents an ideal model to evaluate the renal 123I-MIBG scintigraphy method. The aim of this study was to evaluate whether renal 123I-MIBG scintigraphy can detect changes in renal sympathetic nervous activity following renal transplantation. Renal 123I-MIBG scintigraphy was performed in eleven renal transplant recipients at 1, 3, and 6 months following transplantation and in their respective living donors prior to their kidney donation. Relative uptake as well as washout was obtained. In transplanted patients, the relative 4 h uptake of 123I-MIBG, as measured by the kidney/background ratio, was 2.7 (0.4) (mean (SD)), 2.7 (0.5), and 2.5 (0.4) at 1, 3, and 6 months post-transplantation, respectively, as compared with the 4.0 (0.4) value in the donor kidney before donor nephrectomy (p < 0.01). There was no significant change in washout-rate between pre-transplantation and any of the follow-up time points. Living donor kidney transplantation was at 6 months post transplantation, associated with an almost 40% reduction in the relative 4 h 123I-MIBG uptake of the kidney. Further studies will help to fully establish its implications as a marker of renal innervation or denervation.

Sympathetic nervous activity in carriers of MC4R mutations

2006 ◽  
Vol 114 (S 1) ◽  
Author(s):  
D Heutling ◽  
F Sayk ◽  
C Dodt ◽  
HL Fehm ◽  
A Hinney ◽  
...  
Keyword(s):  
Nervous Activity ◽  
Sympathetic Nervous Activity ◽  
Sympathetic Nervous

Sympathetic nervous activity in patients with chronic renal failure

1994 ◽  
Vol 1 ◽  
pp. 314
Author(s):  
E. Gotoh ◽  
T. Matsukawa ◽  
S. Sumita ◽  
K. Ashino ◽  
N. Takagi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Nervous Activity ◽  
Sympathetic Nervous Activity ◽  
Sympathetic Nervous
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