|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1993; 22:1425-1432 © 1993 by the American College of Cardiology Foundation |
Department of Internal Medicine, University of Michigan, Ann Arbor.
OBJECTIVES. The purpose of this investigation was to evaluate the sympathetic nervous system of the heart by positron emission tomographic (PET) imaging in patients with diabetes mellitus with and without diabetic autonomic neuropathy. BACKGROUND. The clinical assessment of cardiac involvement in diabetic autonomic neuropathy has been limited to cardiovascular reflex testing. With the recent introduction of radiolabeled catecholamines such as carbon (C)-11 hydroxyephedrine, the sympathetic innervation of the heart can be specifically visualized with PET imaging. METHODS. Positron emission tomographic imaging was performed with C-11 hydroxyephedrine and rest myocardial blood flow imaging with nitrogen-13 ammonia. Three patient groups were studied, including healthy volunteers as control subjects, diabetic patients with normal autonomic function testing and diabetic patients with varying severity of autonomic neuropathy. Homogeneity of cardiac tracer retention as well as absolute tracer retention was determined by relating myocardial tracer retention to an arterial C-11 activity input function. RESULTS. Abnormal regional C-11 hydroxyephedrine retention was seen in seven of eight patients with autonomic neuropathy. Relative tracer retention was significantly reduced in apical, inferior and lateral segments. The extent of the abnormality correlated with the severity of conventional markers of autonomic dysfunction. Absolute myocardial tracer retention index measurements showed a 45 +/- 21% decrease in distal compared with proximal myocardial segments in autonomic neuropathy (0.069 +/- 0.037 min-1 vs. 0.13 +/- 0.052 min-1, p = 0.02). CONCLUSIONS. This study demonstrates a heterogeneous pattern of neuronal abnormalities in patients with diabetic cardiac neuropathy. The extent of this abnormality correlated with the severity of neuropathy assessed by conventional tests. Future studies in larger groups of patients are required to define the relative sensitivity of this imaging approach in detecting cardiac neuropathy and to determine the clinical significance of these scintigraphic findings in comparison with conventional markers of autonomic innervation.
This article has been cited by other articles:
|
|
 |
|
  J. J. Bax, O. Kraft, A. E. Buxton, J. G. Fjeld, P. Parizek, D. Agostini, J. Knuuti, A. Flotats, J. Arrighi, A. Muxi, et al. 123I-mIBG Scintigraphy to Predict Inducibility of Ventricular Arrhythmias on Cardiac Electrophysiology Testing: A Prospective Multicenter Pilot Study Circ Cardiovasc Imaging, September 1, 2008; 1(2): 131 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Raffel, R. A. Koeppe, R. Little, C.-N. Wang, S. Liu, L. Junck, M. Heumann, and S. Gilman PET Measurement of Cardiac and Nigrostriatal Denervation in Parkinsonian Syndromes J. Nucl. Med., November 1, 2006; 47(11): 1769 - 1777. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Raffel, W. Chen, P. S. Sherman, D. L. Gildersleeve, and Y.-W. Jung Dependence of Cardiac 11C-meta-Hydroxyephedrine Retention on Norepinephrine Transporter Density J. Nucl. Med., September 1, 2006; 47(9): 1490 - 1496. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Y. Fang, J. B. Prins, and T. H. Marwick Diabetic Cardiomyopathy: Evidence, Mechanisms, and Therapeutic Implications Endocr. Rev., August 1, 2004; 25(4): 543 - 567. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H Laine, J Sundell, P Nuutila, O T Raitakari, M Luotolahti, T Ronnemaa, T Elomaa, P Koskinen, and J Knuuti Insulin induced increase in coronary flow reserve is abolished by dexamethasone in young men with uncomplicated type 1 diabetes Heart, March 1, 2004; 90(3): 270 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K Foo, N Sekhri, A Deaner, C Knight, A Suliman, K Ranjadayalan, and A D Timmis Effect of diabetes on serum potassium concentrations in acute coronary syndromes Heart, January 1, 2003; 89(1): 31 - 35. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Taskiran, T. Fritz-Hansen, V. Rasmussen, H. B.W. Larsson, and J. Hilsted Decreased Myocardial Perfusion Reserve in Diabetic Autonomic Neuropathy Diabetes, November 1, 2002; 51(11): 3306 - 3310. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Munch, N. T. B. Nguyen, S. Nekolla, S. Ziegler, O. Muzik, P. Chakraborty, D. M. Wieland, and M. Schwaiger Evaluation of Sympathetic Nerve Terminals With [11C]Epinephrine and [11C]Hydroxyephedrine and Positron Emission Tomography Circulation, February 8, 2000; 101(5): 516 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Di Carli, D. Bianco-Batlles, M. E. Landa, A. Kazmers, H. Groehn, O. Muzik, and G. Grunberger Effects of Autonomic Neuropathy on Coronary Blood Flow in Patients With Diabetes Mellitus Circulation, August 24, 1999; 100(8): 813 - 819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. M. Bengel, P. Ueberfuhr, S. I. Ziegler, S. Nekolla, B. Reichart, and M. Schwaiger Serial Assessment of Sympathetic Reinnervation After Orthotopic Heart Transplantation : A Longitudinal Study Using PET and C-11 Hydroxyephedrine Circulation, April 13, 1999; 99(14): 1866 - 1871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F Hartmann, S Ziegler, S Nekolla, M Hadamitzky, M Seyfarth, G Richardt, and M Schwaiger Regional patterns of myocardial sympathetic denervation in dilated cardiomyopathy: an analysis using carbon-11 hydroxyephedrine and positron emission tomography Heart, March 1, 1999; 81(3): 262 - 270. [Abstract] [Full Text]
|
|
|
|
|
|
J. E. Olgin, H. J. Sih, S. Hanish, J. V. Jayachandran, J. Wu, Q. H. Zheng, W. Winkle, G. K. Mulholland, D. P. Zipes, and G. Hutchins Heterogeneous Atrial Denervation Creates Substrate for Sustained Atrial Fibrillation Circulation, December 8, 1998; 98(23): 2608 - 2614. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Stevens, D. M. Raffel, K. C. Allman, F. Dayanikli, E. Ficaro, T. Sandford, D. M. Wieland, M. A. Pfeifer, and M. Schwaiger Cardiac Sympathetic Dysinnervation in Diabetes : Implications for Enhanced Cardiovascular Risk Circulation, September 8, 1998; 98(10): 961 - 968. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ungerer, F. Hartmann, M. Karoglan, A. Chlistalla, S. Ziegler, G. Richardt, M. Overbeck, H. Meisner, A. Schomig, and M. Schwaiger Regional In Vivo and In Vitro Characterization of Autonomic Innervation in Cardiomyopathic Human Heart Circulation, January 20, 1998; 97(2): 174 - 180. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Malizia, G. Forse, A. Haida, R. Gunn, J. Melichar, K. Poole, D. Bateman, D. Fahy, L. Schnorr, D. Brown, et al. A new human (psycho)pharmacology tool: the multiple organs coincidences counter (MOCC) J Psychopharmacol, January 1, 1995; 9(4): 294 - 306. [Abstract] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
