Myocardial 123I-MIBG kinetics in acutely hypothyroid patients with differentiated thyroid carcinoma

Carlo Ludovico Maini, A. Tofani, R. Sciuto, A. Ferraironi, A. Festa, S. Rea

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Marked changes in cardiac function have been noted in patients with hyperthyroidism or hypothyroidism due both to changes in sympathetic system function and to biochemical modifications of myocardial tissue. Metaiodobenzylguanidine (MIBG), an analogue of norepinephrine, can be used to evaluate myocardial sympathetic tone. Here, we report myocardial 123I-MIBG kinetics in patients with differentiated thyroid carcinoma undergoing acute hypothyroidism followed by hormonal replacement as part of their routine clinical follow-up. Ten patients with differentiated thyroid carcinoma in acute hypothyroidism (A) and on hormonal replacement with thyroxine (150 μg·day-1) and triiodothyronine (20 μg·day-1) (B) underwent scintigraphic imaging 20 min and 4 h after injection of 111 MBq of ultra-high specific activity 123I-MIBG. No patient had cardiac disease or was taking medications that could interfere with cardiac or autonomic system function. Cardiac MIBG kinetics (heart-to-mediastinum, H/M, ratio and myocardial washout rate), serum norepinephrine, T3, T4, FT3, FT4, TSH, CPK, CPK-MB, blood pressure and ECG were evaluated. Systolic and diastolic blood pressure did not differ significantly between state A and state B. In the acute hypothyroid state (A), the prevalence of non-specific ST-T abnormalities was 70% and heart rate was significantly different (P <0.001) than in state B. Norepinephrine and CPK-MB levels were higher during hypothyroidism, but this did not reach statistical significance. A positive correlation between early H/M and delayed H/M in the hypothyroid state (r = 0.57) and an even higher positive correlation between early H/M and delayed H/M in the euthyroid state (r = 0.91) were seen. The myocardial and mediastinal MIBG washout rates were significantly different between the hypothyroid and euthyroid states (P <0.05), whereas the lung washout rate did not differ significantly between the two metabolic states. We conclude that the myocardial washout rate during hypothyroidism is clearly increased (P <0.005) with a subclinical derangement of myocardial adrenergic innervation, which is rapidly reversed with hormonal therapy.

Original languageEnglish
Pages (from-to)719-726
Number of pages8
JournalNuclear Medicine Communications
Volume20
Issue number8
Publication statusPublished - 1999

Fingerprint

Hypothyroidism
Thyroid Neoplasms
Norepinephrine
Blood Pressure
Mediastinum
Triiodothyronine
Hyperthyroidism
Thyroxine
Adrenergic Agents
Heart Diseases
Electrocardiography
Heart Rate
Lung
Injections
Serum
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Myocardial 123I-MIBG kinetics in acutely hypothyroid patients with differentiated thyroid carcinoma. / Maini, Carlo Ludovico; Tofani, A.; Sciuto, R.; Ferraironi, A.; Festa, A.; Rea, S.

In: Nuclear Medicine Communications, Vol. 20, No. 8, 1999, p. 719-726.

Research output: Contribution to journalArticle

Maini, CL, Tofani, A, Sciuto, R, Ferraironi, A, Festa, A & Rea, S 1999, 'Myocardial 123I-MIBG kinetics in acutely hypothyroid patients with differentiated thyroid carcinoma', Nuclear Medicine Communications, vol. 20, no. 8, pp. 719-726.
Maini, Carlo Ludovico ; Tofani, A. ; Sciuto, R. ; Ferraironi, A. ; Festa, A. ; Rea, S. / Myocardial 123I-MIBG kinetics in acutely hypothyroid patients with differentiated thyroid carcinoma. In: Nuclear Medicine Communications. 1999 ; Vol. 20, No. 8. pp. 719-726.
@article{ec33962dae874472a491ebf78358d4d0,
title = "Myocardial 123I-MIBG kinetics in acutely hypothyroid patients with differentiated thyroid carcinoma",
abstract = "Marked changes in cardiac function have been noted in patients with hyperthyroidism or hypothyroidism due both to changes in sympathetic system function and to biochemical modifications of myocardial tissue. Metaiodobenzylguanidine (MIBG), an analogue of norepinephrine, can be used to evaluate myocardial sympathetic tone. Here, we report myocardial 123I-MIBG kinetics in patients with differentiated thyroid carcinoma undergoing acute hypothyroidism followed by hormonal replacement as part of their routine clinical follow-up. Ten patients with differentiated thyroid carcinoma in acute hypothyroidism (A) and on hormonal replacement with thyroxine (150 μg·day-1) and triiodothyronine (20 μg·day-1) (B) underwent scintigraphic imaging 20 min and 4 h after injection of 111 MBq of ultra-high specific activity 123I-MIBG. No patient had cardiac disease or was taking medications that could interfere with cardiac or autonomic system function. Cardiac MIBG kinetics (heart-to-mediastinum, H/M, ratio and myocardial washout rate), serum norepinephrine, T3, T4, FT3, FT4, TSH, CPK, CPK-MB, blood pressure and ECG were evaluated. Systolic and diastolic blood pressure did not differ significantly between state A and state B. In the acute hypothyroid state (A), the prevalence of non-specific ST-T abnormalities was 70{\%} and heart rate was significantly different (P <0.001) than in state B. Norepinephrine and CPK-MB levels were higher during hypothyroidism, but this did not reach statistical significance. A positive correlation between early H/M and delayed H/M in the hypothyroid state (r = 0.57) and an even higher positive correlation between early H/M and delayed H/M in the euthyroid state (r = 0.91) were seen. The myocardial and mediastinal MIBG washout rates were significantly different between the hypothyroid and euthyroid states (P <0.05), whereas the lung washout rate did not differ significantly between the two metabolic states. We conclude that the myocardial washout rate during hypothyroidism is clearly increased (P <0.005) with a subclinical derangement of myocardial adrenergic innervation, which is rapidly reversed with hormonal therapy.",
author = "Maini, {Carlo Ludovico} and A. Tofani and R. Sciuto and A. Ferraironi and A. Festa and S. Rea",
year = "1999",
language = "English",
volume = "20",
pages = "719--726",
journal = "Nuclear Medicine Communications",
issn = "0143-3636",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Myocardial 123I-MIBG kinetics in acutely hypothyroid patients with differentiated thyroid carcinoma

AU - Maini, Carlo Ludovico

AU - Tofani, A.

AU - Sciuto, R.

AU - Ferraironi, A.

AU - Festa, A.

AU - Rea, S.

PY - 1999

Y1 - 1999

N2 - Marked changes in cardiac function have been noted in patients with hyperthyroidism or hypothyroidism due both to changes in sympathetic system function and to biochemical modifications of myocardial tissue. Metaiodobenzylguanidine (MIBG), an analogue of norepinephrine, can be used to evaluate myocardial sympathetic tone. Here, we report myocardial 123I-MIBG kinetics in patients with differentiated thyroid carcinoma undergoing acute hypothyroidism followed by hormonal replacement as part of their routine clinical follow-up. Ten patients with differentiated thyroid carcinoma in acute hypothyroidism (A) and on hormonal replacement with thyroxine (150 μg·day-1) and triiodothyronine (20 μg·day-1) (B) underwent scintigraphic imaging 20 min and 4 h after injection of 111 MBq of ultra-high specific activity 123I-MIBG. No patient had cardiac disease or was taking medications that could interfere with cardiac or autonomic system function. Cardiac MIBG kinetics (heart-to-mediastinum, H/M, ratio and myocardial washout rate), serum norepinephrine, T3, T4, FT3, FT4, TSH, CPK, CPK-MB, blood pressure and ECG were evaluated. Systolic and diastolic blood pressure did not differ significantly between state A and state B. In the acute hypothyroid state (A), the prevalence of non-specific ST-T abnormalities was 70% and heart rate was significantly different (P <0.001) than in state B. Norepinephrine and CPK-MB levels were higher during hypothyroidism, but this did not reach statistical significance. A positive correlation between early H/M and delayed H/M in the hypothyroid state (r = 0.57) and an even higher positive correlation between early H/M and delayed H/M in the euthyroid state (r = 0.91) were seen. The myocardial and mediastinal MIBG washout rates were significantly different between the hypothyroid and euthyroid states (P <0.05), whereas the lung washout rate did not differ significantly between the two metabolic states. We conclude that the myocardial washout rate during hypothyroidism is clearly increased (P <0.005) with a subclinical derangement of myocardial adrenergic innervation, which is rapidly reversed with hormonal therapy.

AB - Marked changes in cardiac function have been noted in patients with hyperthyroidism or hypothyroidism due both to changes in sympathetic system function and to biochemical modifications of myocardial tissue. Metaiodobenzylguanidine (MIBG), an analogue of norepinephrine, can be used to evaluate myocardial sympathetic tone. Here, we report myocardial 123I-MIBG kinetics in patients with differentiated thyroid carcinoma undergoing acute hypothyroidism followed by hormonal replacement as part of their routine clinical follow-up. Ten patients with differentiated thyroid carcinoma in acute hypothyroidism (A) and on hormonal replacement with thyroxine (150 μg·day-1) and triiodothyronine (20 μg·day-1) (B) underwent scintigraphic imaging 20 min and 4 h after injection of 111 MBq of ultra-high specific activity 123I-MIBG. No patient had cardiac disease or was taking medications that could interfere with cardiac or autonomic system function. Cardiac MIBG kinetics (heart-to-mediastinum, H/M, ratio and myocardial washout rate), serum norepinephrine, T3, T4, FT3, FT4, TSH, CPK, CPK-MB, blood pressure and ECG were evaluated. Systolic and diastolic blood pressure did not differ significantly between state A and state B. In the acute hypothyroid state (A), the prevalence of non-specific ST-T abnormalities was 70% and heart rate was significantly different (P <0.001) than in state B. Norepinephrine and CPK-MB levels were higher during hypothyroidism, but this did not reach statistical significance. A positive correlation between early H/M and delayed H/M in the hypothyroid state (r = 0.57) and an even higher positive correlation between early H/M and delayed H/M in the euthyroid state (r = 0.91) were seen. The myocardial and mediastinal MIBG washout rates were significantly different between the hypothyroid and euthyroid states (P <0.05), whereas the lung washout rate did not differ significantly between the two metabolic states. We conclude that the myocardial washout rate during hypothyroidism is clearly increased (P <0.005) with a subclinical derangement of myocardial adrenergic innervation, which is rapidly reversed with hormonal therapy.

UR - http://www.scopus.com/inward/record.url?scp=0032587279&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032587279&partnerID=8YFLogxK

M3 - Article

C2 - 10451880

AN - SCOPUS:0032587279

VL - 20

SP - 719

EP - 726

JO - Nuclear Medicine Communications

JF - Nuclear Medicine Communications

SN - 0143-3636

IS - 8

ER -