Abnormal Myocardial Uptake and Clearance of 123I-labeled Metaiodobenzylguanidine in Patients with Chronic Renal Failure and Autonomic Dysfunction

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 1996 Nov 1

PMID 8989675

Citations 3

Authors

H Miyanaga

S Yoneyama

T Kamitani

S Kawasaki

T Takahashi

H Kunishige

Affiliations

Soon will be listed here.

Abstract

Background: Patients with chronic renal failure were evaluated with 123I-labeled metaiodobenzylguanidine (MIBG) myocardial scintigraphy to investigate the relationship between abnormal findings on MIBG scintigrams and autonomic dysfunction.

Methods And Results: Eleven control subjects and 20 patients with chronic renal failure (CRF) (serum creatinine level > 8 mg/dl) were evaluated by MIBG myocardial scintigraphy and power spectral analysis (PSA) of the R-R fluctuations of the electrocardiogram. Subjects with CRF were divided into two groups: without (CRF1; nine patients) or with (CRF2; 11 patients) autonomic neuropathy. From MIBG images, the heart/mediastinum mean count rate, defect score, which was scored visually, and clearance rate were calculated. Percent low-frequency power and high-frequency power were obtained from PSA. MIBG scintigrams showed decreased heart/mediastinum mean count rate, a high defect score in both initial and delayed images, and rapid clearance rate in the CRF2 group. PSA showed an abnormally low percent low-frequency power and high-frequency power in the CRF2 group. In addition, there was a weak but significant inverse correlation between percent low-frequency power and defect score.

Conclusion: Alterations in MIBG scintigrams are seen in patients with autonomic dysfunction in CRF and may be useful for evaluating cardiac sympathetic dysfunction in those patients.

Citing Articles

Autonomic Cardiovascular Alterations in Chronic Kidney Disease: Effects of Dialysis, Kidney Transplantation, and Renal Denervation.

Quarti-Trevano F, Seravalle G, DellOro R, Mancia G, Grassi G Curr Hypertens Rep. 2021; 23(2):10.

PMID: 33582896 PMC: 7882573. DOI: 10.1007/s11906-021-01129-6.

Cardiac sympathetic dysautonomia in children with chronic kidney disease.

Parisotto V, Lima E, Silva J, de Sousa M, Ribeiro A J Nucl Cardiol. 2008; 15(2):246-54.

PMID: 18371597 DOI: 10.1016/j.nuclcard.2008.01.003.

Normal values and within-subject variability of cardiac I-123 MIBG scintigraphy in healthy individuals: implications for clinical studies.

Somsen G, Verberne H, Fleury E, Righetti A J Nucl Cardiol. 2004; 11(2):126-33.

PMID: 15052243 DOI: 10.1016/j.nuclcard.2003.10.010.

References

Satoh K, Katoh K, Murata H, Nishimura S, Yamaguchi H . [Assessment of ischemic damage of the cardiac sympathetic nerve function by semiquantitative analysis of 123I-MIBG (metaiodobenzylguanidine)-SPECT--comparison with 201Tl-Cl-SPECT]. Kaku Igaku. 1990; 27(8):821-31. View

Ewing D, Winney R . Autonomic function in patients with chronic renal failure on intermittent haemodialysis. Nephron. 1975; 15(6):424-9. DOI: 10.1159/000180525. View

Lin Y, Wang J, Shum A, Jiang H, Lai W, Lu K . Role of plasma catecholamines, autonomic, and left ventricular function in normotensive and hypotension prone dialysis patients. ASAIO J. 1993; 39(4):946-53. View

Mantysaari M, Kuikka J, Mustonen J, Tahvanainen K, Vanninen E, Lansimies E . Noninvasive detection of cardiac sympathetic nervous dysfunction in diabetic patients using [123I]metaiodobenzylguanidine. Diabetes. 1992; 41(9):1069-75. DOI: 10.2337/diab.41.9.1069. View

Henderson E, Kahn J, Corbett J, Jansen D, Pippin J, Kulkarni P . Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy. Circulation. 1988; 78(5 Pt 1):1192-9. DOI: 10.1161/01.cir.78.5.1192. View

Nakajo M, Shimabukuro K, Miyaji N, Shimada J, Shirono K, Sakata H . Rapid clearance of iodine-131 MIBG from the heart and liver of patients with adrenergic dysfunction and pheochromocytoma. J Nucl Med. 1985; 26(4):357-65. View

Kersh E, KRONFIELD S, Unger A, POPPER R, Cantor S, Cohn K . Autonomic insufficiency in uremia as a cause of hemodialysis-induced hypotension. N Engl J Med. 1974; 290(12):650-3. DOI: 10.1056/NEJM197403212901203. View

Nakajo M, Shapiro B, Glowniak J, Sisson J, BEIERWALTES W . Inverse relationship between cardiac accumulation of meta-[131I]iodobenzylguanidine (I-131 MIBG) and circulating catecholamines in suspected pheochromocytoma. J Nucl Med. 1983; 24(12):1127-34. View

Tajiri M . [A clinical study of persistent hypotension in patients on chronic hemodialysis]. Nihon Jinzo Gakkai Shi. 1993; 35(3):223-31. View

10.

Daul A, Wang X, Michel M, Brodde O . Arterial hypotension in chronic hemodialyzed patients. Kidney Int. 1987; 32(5):728-35. DOI: 10.1038/ki.1987.267. View

11.

Agarwal A, Anand I, Sakhuja V, Chugh K . Effect of dialysis and renal transplantation on autonomic dysfunction in chronic renal failure. Kidney Int. 1991; 40(3):489-95. DOI: 10.1038/ki.1991.236. View

12.

Nishimura T, Uehara T, Oka H, Kumita S, Mitani I, Yokota I . [Serial assessment of denervated but viable myocardium following acute myocardial infarction by using 123I-MIBG and 201TlCl myocardial SPECT]. Kaku Igaku. 1990; 27(7):709-18. View

13.

Kline R, Swanson D, Wieland D, Thrall J, Gross M, Pitt B . Myocardial imaging in man with I-123 meta-iodobenzylguanidine. J Nucl Med. 1981; 22(2):129-32. View

14.

Pomeranz B, Macaulay R, Caudill M, Kutz I, Adam D, Gordon D . Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol. 1985; 248(1 Pt 2):H151-3. DOI: 10.1152/ajpheart.1985.248.1.H151. View

15.

Binkley P, Nunziata E, Haas G, Nelson S, Cody R . Parasympathetic withdrawal is an integral component of autonomic imbalance in congestive heart failure: demonstration in human subjects and verification in a paced canine model of ventricular failure. J Am Coll Cardiol. 1991; 18(2):464-72. DOI: 10.1016/0735-1097(91)90602-6. View

16.

Malliani A, Pagani M, Lombardi F, Cerutti S . Cardiovascular neural regulation explored in the frequency domain. Circulation. 1991; 84(2):482-92. DOI: 10.1161/01.cir.84.2.482. View

17.

Nishimura T, Kurita T, Ohe T, Hayashida K, Uehara T, Mitani I . [A case of myocardial infarction with ventricular tachycardia, which had discrepancy of defect size between 123I-MIBG and 201TlCl myocardial imaging]. Kaku Igaku. 1989; 26(3):419-23. View

18.

Carretta R, Fabris B, Fischetti F, Bardelli M, Muiesan S, Vran F . Peripheral adrenoceptors in hypotension of hemodialyzed uremic patients. Nephron. 1992; 62(4):429-33. DOI: 10.1159/000187093. View

19.

Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P . Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res. 1986; 59(2):178-93. DOI: 10.1161/01.res.59.2.178. View

20.

Wieland D, Wu J, Brown L, Mangner T, Swanson D, BEIERWALTES W . Radiolabeled adrenergi neuron-blocking agents: adrenomedullary imaging with [131I]iodobenzylguanidine. J Nucl Med. 1980; 21(4):349-53. View