Ongoing myocardial damage relates to cardiac sympathetic nervous disintegrity in patients with heart failure
Ongoing myocardial damage relates to cardiac sympathetic nervous disintegrity in patients with heart failure
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DOI：
10.1007/bf02985045
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发表时间：
2005-10-01
影响因子：
2.6
通讯作者：
Kubota, I
中科院分区：
文献类型：
--
作者：
Arimoto, T;Takeishi, Y;Kubota, I
碘-123-间碘苄胍（I-123-MIBG）已被用于评估心力衰竭患者心脏交感神经系统的完整性和功能。心脏型脂肪酸结合蛋白（H-FABP）在心肌损伤时释放到循环中，并且H-FABP最近已被用作诊断持续心肌损伤的新标记物。目的：本研究的目的是比较心脏交感神经活动评估I-123-MIBG成像与血清H-FABP水平在心力衰竭患者。方法：50例慢性心力衰竭患者。在示踪剂注射后30 min（早期）和240 min（延迟）进行I-123-MIBG显像。我们用夹心酶联免疫吸附试验测定血清H-FABP水平。结果如下：随着纽约心脏协会（NYHA）心功能分级的升高，I-123-MIBG的心脏与纵隔（H/M）比值降低，洗脱率增加。H-FABP、去甲肾上腺素和脑钠肽（BNP）水平随NYHA分级的严重程度增加而增加。延迟H/M比值与H-FABP（r =-0.296，p =0.029）和BNP（r =-0.335，p =0.0213）显著相关。I-123-MIBG的心肌洗脱率也与H-FABP（r = 0.469，p <0.001）、去甲肾上腺素（r = 0.433，p = 0.005）和BNP（r = 0.465，p = 0.001）相关。结论：这些数据表明，心脏交感神经激活与正在进行的心肌细胞损伤，其特征是在心力衰竭患者的血清H-FABP水平升高。I-123-MIBG成像是一种合适的方法，不仅可以无创地评估心脏交感神经活动，而且可以评估衰竭心脏中潜在的持续心肌损伤。
Iodine-123-metaiodobenzylguanidine (I-123-MIBG) has been used to assess the integrity and function of the cardiac sympathetic nervous system in patients with heart failure. Heart-type fatty acid binding protein (H-FABP) is released into the circulation when the myocardium is injured, and H-FABP has been recently used as a novel marker for the diagnosis of ongoing myocardial damage. Objective: The aim of the present study was to compare cardiac sympathetic nervous activity assessed by I-123-MIBG imaging with serum levels of H-FABP in patients with heart failure. Methods: Fifty patients with chronic heart failure were studied. I-123-MIBG imaging was carried out at 30 min (early) and 240 min (delayed) after the tracer injection. We measured serum levels of H-FABP using a sandwich enzyme linked immunosorbent assay. Results: Heart to mediastinum (H/M) ratios of I-123-MIBG decreased and washout rate increased with higher New York Heart Association (NYHA) functional class. H-FABP, norepinephrine and brain natriuretic peptide (BNP) levels increased as the severity of NYHA class advanced. Delayed H/M ratio was significantly correlated with H-FABP (r = -0.296, p = 0.029) and BNP (r = -0.335, p = 0.0213). Myocardial washout rate of I-123-MIBG was also correlated with H-FABP (r = 0.469, p < 0.001), norepinephrine (r = 0.433, p = 0.005), and BNP (r = 0.465, p = 0.001). Conclusions: These data suggest that cardiac sympathetic nervous activation was associated with ongoing cardiomyocyte damage characterized by an elevated serum level of H-FABP in patients with heart failure. I-123-MIBG imaging is an appropriate approach to evaluate non-invasively not only cardiac sympathetic nervous activity, but also latent ongoing myocardial damage in the failing heart.