PMID- 20503121
OWN - NLM
STAT- MEDLINE
DCOM- 20110111
LR  - 20240130
IS  - 1532-6551 (Electronic)
IS  - 1071-3581 (Linking)
VI  - 17
IP  - 5
DP  - 2010 Oct
TI  - Norepinephrine spillover during exercise as a novel parameter to evaluate the 
      severity of heart failure.
PG  - 868-73
LID - 10.1007/s12350-010-9241-3 [doi]
AB  - BACKGROUND: The washout rate (WR) of (123)I-metaiodobenzylguanidine (MIBG) is now 
      widely used for assessing the severity of heart failure. Although the WR of MIBG 
      is usually measured at rest, the assessment of WR of MIBG during exercise might 
      have a different clinical relevance. In this study, we measured the WR rate of 
      MIBG during low-grade exercise and studied the clinical importance of this novel 
      index. METHODS: Twenty-four patients with dilated cardiomyopathy (DCM) were 
      enrolled in this study. Planar images were obtained 20 minutes after MIBG 
      injection (first image) and after 270 minutes (second image); the third image was 
      obtained after 15 minutes of low-grade (10 W) bicycle ergometer exercise 
      (300 minutes after MIBG injection). The decay of the specific counts was 
      calculated from the first two images. The estimated third counts were calculated 
      from the resting decay and were compared with the actual third counts. RESULTS: 
      In the receiver operating characteristic (ROC) curve analysis, we set a 10% 
      decrease from the estimated counts as a cut-off value for severe heart failure 
      (New York Heart Association [NYHA] Class IIm or worse). In 15 patients, the 
      actual third count value was within 10% of the estimated count (N-group). In nine 
      patients, the WR during exercise was high, and the actual third count values 
      showed more than a 10% decrease from the estimated count value (H-group). In the 
      H-group, 78% of the patients were in NYHA class IIm or III. In contrast, in the 
      N-group, no patient had NYHA class III, and only 20% of the patients were in 
      class IIm. The brain natriuretic peptide (BNP) level was significantly higher in 
      the H-group than in the N-group (525 +/- 263 pg/mL vs 176 +/- 144 pg/mL; P < .01). No 
      significant differences were observed in heart/mediastinal (H/M) activity ratio, 
      the regular WR, and left ventricular ejection fraction values between the two 
      groups. CONCLUSIONS: The WR of MIBG during exercise may be an independent 
      prediction variable, with a clinical relevance different from that of the WR at 
      rest. This measurement could be used as a new index for assessing the severity of 
      heart failure.
FAU - Ando, Miyuki
AU  - Ando M
AD  - Department of Medicine and Clinical Science, Yamaguchi University Graduate School 
      of Medicine, 1-1-1 Minamikogushi, Ube 755-8505, Japan.
FAU - Yamamoto, Takeshi
AU  - Yamamoto T
FAU - Hino, Akihiro
AU  - Hino A
FAU - Sato, Takashi
AU  - Sato T
FAU - Nakamura, Yasuma
AU  - Nakamura Y
FAU - Matsuzaki, Masunori
AU  - Matsuzaki M
LA  - eng
PT  - Journal Article
DEP - 20100526
PL  - United States
TA  - J Nucl Cardiol
JT  - Journal of nuclear cardiology : official publication of the American Society of 
      Nuclear Cardiology
JID - 9423534
RN  - 0 (Radiopharmaceuticals)
RN  - 35MRW7B4AD (3-Iodobenzylguanidine)
RN  - X4W3ENH1CV (Norepinephrine)
SB  - IM
MH  - 3-Iodobenzylguanidine/*pharmacokinetics
MH  - Adult
MH  - Aged
MH  - *Exercise
MH  - Female
MH  - Heart Failure/diagnostic imaging/*metabolism
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Norepinephrine/*metabolism
MH  - Radionuclide Imaging
MH  - Radiopharmaceuticals/*pharmacokinetics
EDAT- 2010/05/27 06:00
MHDA- 2011/01/12 06:00
CRDT- 2010/05/27 06:00
PHST- 2009/12/09 00:00 [received]
PHST- 2010/04/15 00:00 [accepted]
PHST- 2010/05/27 06:00 [entrez]
PHST- 2010/05/27 06:00 [pubmed]
PHST- 2011/01/12 06:00 [medline]
AID - S1071-3581(23)04147-8 [pii]
AID - 10.1007/s12350-010-9241-3 [doi]
PST - ppublish
SO  - J Nucl Cardiol. 2010 Oct;17(5):868-73. doi: 10.1007/s12350-010-9241-3. Epub 2010 
      May 26.