Scintigraphic assessment of sympathetic innervation after transmural versus nontransmural myocardial infarction

Journal Article · Wed May 01 04:00:00 EDT 1991 · Journal of the American College of Cardiology; (USA)

DOI:https://doi.org/10.1016/S0735-1097(10)80156-1· OSTI ID:5643426

Dae, M W; Herre, J M; O'Connell, J W; Botvinick, E H; Newman, D; Munoz, L ^[1]

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1. University of California, San Francisco (USA)

To evaluate the feasibility of detecting denervated myocardium in the infarcted canine heart, the distribution of sympathetic nerve endings using I-123 metaiodobenzylguanidine (MIBG) was compared with the distribution of perfusion using thallium-201, with the aid of color-coded computer functional map in 16 dogs. Twelve dogs underwent myocardial infarction by injection of vinyl latex into the left anterior descending coronary artery (transmural myocardial infarction, n = 6), or ligation of the left anterior descending coronary artery (nontransmural myocardial infarction, n = 6). Four dogs served as sham-operated controls. Image patterns were compared with tissue norepinephrine content and with histofluorescence microscopic findings in biopsy specimens. Hearts with transmural infarction showed zones of absent MIBG and thallium, indicating scar. Adjacent and distal regions showed reduced MIBG but normal thallium uptake, indicating viable but denervated myocardium. Denervation distal to infarction was confirmed by reduced norepinephrine content and absence of nerve fluorescence. Nontransmural myocardial infarction showed zones of wall thinning with decreased thallium uptake and a greater reduction or absence of MIBG localized to the region of the infarct, with minimal extension of denervation beyond the infarct. Norepinephrine content was significantly reduced in the infarct zone, and nerve fluorescence was absent. These findings suggest that (1) MIBG imaging can detect viable and perfused but denervated myocardium after infarction; and (2) as opposed to the distal denervation produced by transmural infarction, nontransmural infarction may lead to regional ischemic damage of sympathetic nerves, but may spare subepicardial nerve trunks that course through the region of infarction to provide a source of innervation to distal areas of myocardium.

• OSTI ID: 5643426
• Journal Information: Journal of the American College of Cardiology; (USA), Journal Name: Journal of the American College of Cardiology; (USA) Vol. 17:6; ISSN 0735-1097; ISSN JACCD
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMALS
ARTERIES
AUTONOMIC NERVOUS SYSTEM
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CONTRAST MEDIA
CORONARIES
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DISTRIBUTION
DOGS
ELASTOMERS
ELECTRON CAPTURE RADIOISOTOPES
FEASIBILITY STUDIES
FLUORESCENCE
HEART
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
IODINE 123
IODINE ISOTOPES
ISOTOPES
LATEX
LUMINESCENCE
MAMMALS
MYOCARDIAL INFARCTION
NERVES
NERVOUS SYSTEM
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANIC POLYMERS
ORGANS
POLYMERS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RUBBERS
SCINTISCANNING
TISSUE DISTRIBUTION
VERTEBRATES