Noninvasive evaluation of sympathetic nervous system in human heart by positron emission tomography.
Noninvasive evaluation of sympathetic nervous system in human heart by positron emission tomography.
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DOI：
10.1161/01.cir.82.2.457
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发表时间：
1990-08
期刊：
影响因子：
37.8
通讯作者：
M. Schwaiger;V. Kalff;K. Rosenspire;M. Haka;E. Molina;G. Hutchins;Michael G. Deeb;E. Wolfe;D. Wieland
中科院分区：
文献类型：
--
作者：
M. Schwaiger;V. Kalff;K. Rosenspire;M. Haka;E. Molina;G. Hutchins;Michael G. Deeb;E. Wolfe;D. Wieland
心脏交感神经系统的无创性功能特性的成像技术可以提供重要的病理生理信息，在各种心脏疾病的状态。11碳标记的羟麻黄碱已被开发为一种新的儿茶酚胺类似物，用于在体评价突触前肾上腺素能神经末梢的正电子发射断层扫描（PET）。为了确定这种成像方法在人体心脏中的可行性，6名正常志愿者和5名近期心脏移植患者在静脉注射20 mCi [11C]羟麻黄碱后进行了动态PET成像。使用感兴趣区域方法评估血液和心肌示踪剂动力学。在正常志愿者中，血液11C活性迅速清除，而心肌保留11C活性，具有较长的组织半衰期。在示踪剂注射后60分钟，心肌中的相对示踪剂保留平均为峰值活性的79 +/-31%。在示踪剂注射后30分钟，心脏与血液的11C活性比超过6：1，产生良好的图像质量。观察到示踪剂保留的区域变化很小，表明整个左心室的交感神经分布均匀。在移植受者中，60分钟时心肌[11C]羟麻黄碱滞留显著低于正常志愿者（-82%），表明在去神经支配的人心脏中只有很少的示踪剂非神经元结合。因此，[11 C]羟麻黄碱，结合动态PET成像，允许心肌肾上腺素能神经末梢的非侵入性描绘。示踪剂动力学建模可以允许定量评估心肌儿茶酚胺摄取，这反过来又会提供洞察各种疾病过程对心脏神经元完整性的影响。
The noninvasive functional characterization of the cardiac sympathetic nervous system by imaging techniques may provide important pathophysiological information in various cardiac disease states. Hydroxyephedrine labeled with carbon 11 has been developed as a new catecholamine analogue to be used in the in vivo evaluation of presynaptic adrenergic nerve terminals by positron emission tomography (PET). To determine the feasibility of this imaging approach in the human heart, six normal volunteers and five patients with recent cardiac transplants underwent dynamic PET imaging after intravenous injection of 20 mCi [11C]hydroxyephedrine. Blood and myocardial tracer kinetics were assessed using a regions-of-interest approach. In normal volunteers, blood 11C activity cleared rapidly, whereas myocardium retained 11C activity with a long tissue half-life. Relative tracer retention in the myocardium averaged 79 +/- 31% of peak activity at 60 minutes after tracer injection. The heart-to-blood 11C activity ratio exceeded 6:1 as soon as 30 minutes after tracer injection, yielding excellent image quality. Little regional variation of tracer retention was observed, indicating homogeneous sympathetic innervation throughout the left ventricle. In the transplant recipients, myocardial [11C]hydroxyephedrine retention at 60 minutes was significantly less (-82%) than that of normal volunteers, indicating only little non-neuronal binding of the tracer in the denervated human heart. Thus, [11C]hydroxyephedrine, in combination with dynamic PET imaging, allows the noninvasive delineation of myocardial adrenergic nerve terminals. Tracer kinetic modeling may permit quantitative assessment of myocardial catecholamine uptake, which will in turn provide insights into the effects of various disease processes on the neuronal integrity of the heart.