Early Therapeutic Effects of Adaptive Servo-ventilation on Cardiac Sympathetic Nervous Function in Patients with Heart Failure Evaluated Using a Combination of C-HED PET and I-MIBG SPECT

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 2017 Nov 29

PMID 29181786

Citations 6

Authors

Yusuke Tokuda

Mamoru Sakakibara

Keiichiro Yoshinaga

Shiro Yamada

Kiwamu Kamiya

Naoya Asakawa

Takashi Yoshitani

Keiji Noguchi

Osamu Manabe

Nagara Tamaki

Hiroyuki Tsutsui

Affiliations

Soon will be listed here.

Abstract

Rationale: Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF.

Methods: We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57.3 ± 17.3 years old, left ventricular ejection fraction (LVEF) 36.1 ± 16.7%]. We performed echocardiography, polysomnography, biomarkers, C-hydroxyephedrine (HED) PET as a presynaptic function marker and planar I-metaiodobenzylguanidine (MIBG) to evaluate washout rate.

Results: ASV therapy reduced apnea-hypopnea index (AHI) and improved plasma brain natriuretic peptide (BNP) concentration. In I-MIBG imaging, the early heart/mediastinum (H/M) ratio increased after ASV therapy (2.19 ± 0.58 to 2.40 ± 0.67; P = 0.045). Washout rate did not change (23.8 ± 7.3% to 23.8 ± 8.8%; P = 0.122). Global C-HED retention index (RI) improved from 0.068 ± 0.033/s to 0.075 ± 0.034/s (P = 0.029).

Conclusions: ASV reduced AHI and improved BNP. ASV might initially improve presynaptic cardiac sympathetic nervous function in HF patients after 6 months of treatment.

Citing Articles

I-MIBG imaging in heart failure: impact of comorbidities on cardiac sympathetic innervation.

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Adaptive Servo-ventilation Therapy Results in the Prevention of Arrhythmias in Patients with Heart Failure Due to Ischemic Heart Disease.

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The prognostic value of I-mIBG SPECT cardiac imaging in heart failure patients: a systematic review.

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How do we establish cardiac sympathetic nervous system imaging with I-mIBG in clinical practice? Perspectives and lessons from Japan and the US.

Travin M, Matsunari I, Thomas G, Nakajima K, Yoshinaga K J Nucl Cardiol. 2018; 26(4):1434-1451.

PMID: 30178272 DOI: 10.1007/s12350-018-1394-5.

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