Highlights
- •Cardiac and renal WR were higher in the HFrEF group than the controls.
- •The increase in WR of renal 123I-MIBG is accompanied by an increase in MSNA.
- •Cardiac MIBG images showed significant correlation with impaired hemodynamics, but not renal MIBG images.
Abstract
Background
Renal denervation is effective for modulating augmented sympathetic nerve activity
(SNA) in heart failure with reduced ejection fraction (HFrEF). We have demonstrated
that renal iodine123-metaiodobenzylguanidine (123I-MIBG) scintigraphy is associated with muscle sympathetic nerve activity (MSNA) in
patients with hypertension. However, it is unclear whether renal 123I-MIBG scintigraphy is useful for assessment of SNA in HFrEF.
Methods
The study population consisted of 24 HFrEF patients and 11 healthy subjects as controls.
Patients with HFrEF underwent 123I-MIBG scintigraphy and hemodynamics using a Swan-Ganz catheter (SGC). HFrEF was defined
as echocardiography with left ventricular ejection fraction (LVEF) < 50%. MSNA was
measured from the peroneal nerve for direct evaluation of SNA. Renal 123I-MIBG scintigraphy was performed simultaneously with cardiac scintigraphy. The early
and delayed kidney-to-mediastinum ratio (K/M), early and delayed heart-to-mediastinum
ratio (H/M), and washout rate (WR) were calculated.
Results
LVEFs were 35% ± 11% in patients with HFrEF and 63% ± 10% in the controls (p < 0.01).
The WR of cardiac 123I-MIBG showed no relation to MSNA, but was related to stroke volume (r = 0.45, p < 0.05).
In contrast, the WR of renal 123I-MIBG scintigraphy (average of both sides) showed a strong correlation with MSNA
(BI, r = 0.70, p < 0.01; BF, r = 0.66, p < 0.01); however, no significant correlations
were detected between renal 123I-MIBG scintigraphy and SGC results.
Conclusions
The WR of renal 123I-MIBG scintigraphy may reflect MSNA. Further studies are needed to clarify the relationship
between renal 123I-MIBG imaging and renal SNA.
Keywords
Abbreviations:
SNA (sympathetic nerve activity), CCr (creatinine clearance), HFrEF (heart failure with reduced ejection fraction), 123I-MIBG (iodine123-metaiodobenzylguanidine), MSNA (muscle sympathetic nerve activity), NE (norepinephrine), BI (burst incidence), BF (burst frequency), K/M (kidney-to-mediastinum ratio), H/M (heart-to-mediastinum ratio), WR (washout rate), RDN (renal denervation), ROI (region of interest), SGC (Swan-Ganz catheter), CO (cardiac output), SV (stroke volume)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 31, 2020
Accepted:
March 29,
2020
Received in revised form:
March 29,
2020
Received:
September 18,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
