PMID- 9225795
OWN - NLM
STAT- MEDLINE
DCOM- 19970807
LR  - 20161124
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 38
IP  - 7
DP  - 1997 Jul
TI  - ACE inhibition reduces cardiac iodine-123-MIBG release in heart failure.
PG  - 1085-9
AB  - Radioiodinated metaiodobenzylguanidine (123I-MIBG), an analog of norepinephrine, 
      has been used to assess cardiac sympathetic nerve activity. Decreased myocardial 
      accumulation and enhanced washout of 123I-MIBG have been reported in patients 
      with congestive heart failure (CHF). The purpose of this study was to determine 
      whether angiotensin converting enzyme (ACE) inhibition reduced 123I-MIBG release 
      and improved cardiac 123I-MIBG accumulation in patients with CHF. METHODS: 
      Twenty-nine patients receiving conventional treatment for CHF, New York Heart 
      Association (NYHA) functional class 2-3, were studied. Nineteen patients received 
      additional treatment with enalapril, an ACE inhibitor, and 10 patients who were 
      treated with conventional therapy alone were defined as a control group. 
      Iodine-123-MIBG imaging and echocardiography were performed on all patients 
      before treatment and repeated after 9.1 +/- 3.0 mo of treatment. Images were 
      obtained 30 min and 4 hr after injection of 123I-MIBG, and a heart to mediastinum 
      (H/M) ratio was defined to quantify cardiac 123I-MIBG uptake as a fraction of the 
      mean counts per pixel in the heart divided by those in the mediastinum. The 
      washout rate of 123I-MIBG from the heart was calculated as follows: (early counts 
      - delayed counts)/early counts x 100(%). RESULTS: In patients with enalapril 
      group, the H/M ratio of 123I-MIBG was increased after treatment (early image: 
      1.60 +/- 0.22 vs. 1.73 +/- 0.28, p < 0.05, delayed image: 1.63 +/- 0.28 vs. 1.82 
      +/- 0.33, p < 0.01). The washout rate of 123I-MIBG was reduced from 38% +/- 11% 
      to 30% +/- 12% after treatment (p < 0.01). However in the conventional therapy 
      group, the H/M ratios in the early and delayed images (early image: 1.58 +/- 0.31 
      vs. 1.52 +/- 0.23, delayed image: 1.49 +/- 0.27 vs. 1.49 +/- 0.25) and the 
      washout rate (34% +/- 8% vs. 33% +/- 7%) remained unchanged after treatment. In 
      patients with an increased H/M ratio of enalapril group (n = 13), a left 
      ventricular ejection fraction increased from 48% +/- 12% to 55% +/- 9% (p < 0.01) 
      after treatment. CONCLUSION: ACE inhibition reduces cardiac 123I-MIBG release and 
      thus lowers cardiac sympathetic nerve activity. Iodine-123-MIBG may be helpful in 
      evaluating the therapeutic effects of ACE inhibition on the cardiac sympathetic 
      nervous system in patients with CHF.
FAU - Takeishi, Y
AU  - Takeishi Y
AD  - First Department of Internal Medicine, Yamagata University School of Medicine, 
      Japan.
FAU - Atsumi, H
AU  - Atsumi H
FAU - Fujiwara, S
AU  - Fujiwara S
FAU - Takahashi, K
AU  - Takahashi K
FAU - Tomoike, H
AU  - Tomoike H
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Iodine Radioisotopes)
RN  - 0 (Iodobenzenes)
RN  - 35MRW7B4AD (3-Iodobenzylguanidine)
RN  - 69PN84IO1A (Enalapril)
SB  - IM
MH  - 3-Iodobenzylguanidine
MH  - Angiotensin-Converting Enzyme Inhibitors/*pharmacology/therapeutic use
MH  - Enalapril/*pharmacology/therapeutic use
MH  - Female
MH  - Heart Failure/diagnostic imaging/drug therapy/*metabolism
MH  - Humans
MH  - Iodine Radioisotopes/*pharmacokinetics
MH  - Iodobenzenes/*pharmacokinetics
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*metabolism
MH  - Radionuclide Imaging
EDAT- 1997/07/01 00:00
MHDA- 1997/07/01 00:01
CRDT- 1997/07/01 00:00
PHST- 1997/07/01 00:00 [pubmed]
PHST- 1997/07/01 00:01 [medline]
PHST- 1997/07/01 00:00 [entrez]
PST - ppublish
SO  - J Nucl Med. 1997 Jul;38(7):1085-9.