Imaging cardiac innervation in amyloidosis

Journal Article · Fri Feb 15 04:00:00 EST 2019 · Journal of Nuclear Cardiology (Online)

DOI:https://doi.org/10.1007/S12350-017-1059-9· OSTI ID:22962188

Hazenberg, Bouke P. C. ^[1]; Noordzij, Walter ^[2]

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1. University Medical Center Groningen, University of Groningen, Department of Rheumatology & Clinical Immunology (Netherlands)
2. University Medical Center Groningen, University of Groningen, Department of Nuclear Medicine and Molecular Imaging (EB50), Medical Imaging Center (Netherlands)

Cardiac amyloidosis is a form of restrictive cardiomyopathy resulting in heart failure and potential risk on arrhythmia, due to amyloid infiltration of the nerve conduction system and the myocardial tissue. The prognosis in this progressive disease is poor, probably due the development of cardiac arrhythmias. Early detection of cardiac sympathetic innervation disturbances has become of major clinical interest, because its occurrence and severity limits the choice of treatment. The use of iodine-123 labelled metaiodobenzylguanidine ([I-123]MIBG), a chemical modified analogue of norepinephrine, is well established in patients with heart failure and plays an important role in evaluation of sympathetic innervation in cardiac amyloidosis. [I-123]MIBG is stored in vesicles in the sympathetic nerve terminals and is not catabolized like norepinephrine. Decreased heart-to-mediastinum ratios on late planar images and increased wash-out rates indicate cardiac sympathetic denervation and are associated with poor prognosis. Single photon emission computed tomography provides additional information and has advantages for evaluating abnormalities in regional distribution in the myocardium. [I-123]MIBG is mainly useful in patients with hereditary and wild-type ATTR cardiac amyloidosis, not in AA and AL amyloidosis. The potential role of positron emission tomography for cardiac sympathetic innervation in amyloidosis has not yet been identified.

• OSTI ID: 22962188
• Journal Information: Journal of Nuclear Cardiology (Online), Journal Name: Journal of Nuclear Cardiology (Online) Journal Issue: 1 Vol. 26; ISSN 1532-6551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
HAZARDS
HEART FAILURE
IODINE 123
MEDIASTINUM
MIBG
MYOCARDIUM
NERVES
NORADRENALINE
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY