Cardiac positron emission tomography imaging with [11c]hydroxyephedrine, a specific tracer for sympathetic nerve endings, and its functional correlates in congestive heart failure - 08/09/11
Abstract |
The integrative mechanisms of autonomic dysfunction in congestive heart failure (CHF) remain poorly understood. We sought to study cardiac retention of [11C]hydroxyephedrine (HED), a specific tracer for sympathetic presynaptic innervation, and its functional correlates in CHF. Thirty patients with mild to moderate heart failure underwent resting cardiac HED positron emission tomography imaging, spectrum analysis testing of systolic pressure and heart rate variability in the resting supine and 70° head-up tilt positions, and testing of baroreflex sensitivity. Compared with control subjects, global myocardial HED retention index was reduced by 30% (p <0.01) in patients with CHF. The HED retention index did not correlate significantly with heart rate variability. However, it correlated with baroreflex sensitivity at rest (r = 0.43, p = 0.05) and with systolic pressure low-frequency (0.03 to 0.15 Hz) variability at head-up tilt (r = 0.76, p <0.01), as well as with low-frequency systolic pressure variability response from baseline to tilt (r = 0.75, p <0.01). We conclude that cardiac HED retention is reduced in patients with CHF. This correlates with blunted vascular sympathetic effector responses during posture-induced reflex activation and baroreflex control of heart rate, suggesting an interdependence between cardiac presynaptic innervation abnormalities and neural mechanisms important to blood pressure maintenance in CHF.
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This study was supported by the Finnish Heart Foundation, Helsinki, Finland, Turku University Foundation, EVO Research fund of the Turku University Central Hospital and Leiras Oy, Turku, Finland. Manuscript received December 30, 1998; revised manuscript received and accepted April 26, 1999. |
Vol 84 - N° 5
P. 568-574 - septembre 1999 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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