Relationship between myocardial 123I-metaiodobenzylguanidine scintigraphic uptake and heart rate variability in patients with syndrome X

G. A. Lanza, A. Giordano, C. Pristipino, M. L. Calcagni, G. Meduri, C. Trani, R. Franceschini, F. Crea, L. Troncone

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Abstract

Background: We have recently demonstrated a striking impairment in cardiac uptake of 123I-metaiodobenzylguanidine (MIBG) in most patients with syndrome X. In this study we investigated the relationship between cardiac MIBG defects and cardiac autonomic activity in these patients. Methods: MIBG myocardial scintigraphy and time-domain and frequency-domain heart rate variability (HRV) were compared in 11 syndrome X patients and 10 healthy controls. Cardiac MIBG uptake was assessed by the heart/mediastinum ratio and a cardiac MIBG uptake defect score (higher values = lower uptake). Results: The heart/mediastinum ratio was lower (1.71 ± 0.6 vs 2.19 ± 0.3, p = 0.03) and MIBG uptake score higher (37.1 ± 32 vs 4.0 ± 2.5, p = 0.005) in syndrome X patients, whereas average HRV values did not differ between the two groups. However, while there were no correlations between MIBG uptake and HRV in controls, in syndrome X patients both the heart/mediastinum ratio and MIBG uptake score correlated significantly with two HRV parameters, specific for vagal activity: the square root of the mean squared differences of consecutive RR intervals (r = 0.73, p = 0.01, and r = -0.67, p = 0.02, respectively), and high frequency (r = 0.64, p = 0.03, and r = -0.74, p = 0.009, respectively). Conclusions: In patients with syndrome X, the impairment in cardiac MIBG uptake was associated with a reduction in HRV indexes mainly reflecting vagal modulation of sinus node, thus suggesting that a predominance of cardiac adrenergic activity may be present in those with abnormal cardiac MIBG scintigraphy.

Original languageEnglish
Pages (from-to)221-225
Number of pages5
JournalItalian Heart Journal
Volume1
Issue number3
Publication statusPublished - 2000

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Heart Rate
Mediastinum
Sinoatrial Node
Myocardial Perfusion Imaging
Radionuclide Imaging
Adrenergic Agents

Keywords

  • I-metaiodo-benzylguanidine myocardial scintigraphy
  • Autonomic function
  • Heart rate variability
  • Syndrome X

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Lanza, G. A., Giordano, A., Pristipino, C., Calcagni, M. L., Meduri, G., Trani, C., ... Troncone, L. (2000). Relationship between myocardial 123I-metaiodobenzylguanidine scintigraphic uptake and heart rate variability in patients with syndrome X. Italian Heart Journal, 1(3), 221-225.

Relationship between myocardial 123I-metaiodobenzylguanidine scintigraphic uptake and heart rate variability in patients with syndrome X. / Lanza, G. A.; Giordano, A.; Pristipino, C.; Calcagni, M. L.; Meduri, G.; Trani, C.; Franceschini, R.; Crea, F.; Troncone, L.

In: Italian Heart Journal, Vol. 1, No. 3, 2000, p. 221-225.

Research output: Contribution to journalArticle

Lanza, GA, Giordano, A, Pristipino, C, Calcagni, ML, Meduri, G, Trani, C, Franceschini, R, Crea, F & Troncone, L 2000, 'Relationship between myocardial 123I-metaiodobenzylguanidine scintigraphic uptake and heart rate variability in patients with syndrome X', Italian Heart Journal, vol. 1, no. 3, pp. 221-225.
Lanza, G. A. ; Giordano, A. ; Pristipino, C. ; Calcagni, M. L. ; Meduri, G. ; Trani, C. ; Franceschini, R. ; Crea, F. ; Troncone, L. / Relationship between myocardial 123I-metaiodobenzylguanidine scintigraphic uptake and heart rate variability in patients with syndrome X. In: Italian Heart Journal. 2000 ; Vol. 1, No. 3. pp. 221-225.
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abstract = "Background: We have recently demonstrated a striking impairment in cardiac uptake of 123I-metaiodobenzylguanidine (MIBG) in most patients with syndrome X. In this study we investigated the relationship between cardiac MIBG defects and cardiac autonomic activity in these patients. Methods: MIBG myocardial scintigraphy and time-domain and frequency-domain heart rate variability (HRV) were compared in 11 syndrome X patients and 10 healthy controls. Cardiac MIBG uptake was assessed by the heart/mediastinum ratio and a cardiac MIBG uptake defect score (higher values = lower uptake). Results: The heart/mediastinum ratio was lower (1.71 ± 0.6 vs 2.19 ± 0.3, p = 0.03) and MIBG uptake score higher (37.1 ± 32 vs 4.0 ± 2.5, p = 0.005) in syndrome X patients, whereas average HRV values did not differ between the two groups. However, while there were no correlations between MIBG uptake and HRV in controls, in syndrome X patients both the heart/mediastinum ratio and MIBG uptake score correlated significantly with two HRV parameters, specific for vagal activity: the square root of the mean squared differences of consecutive RR intervals (r = 0.73, p = 0.01, and r = -0.67, p = 0.02, respectively), and high frequency (r = 0.64, p = 0.03, and r = -0.74, p = 0.009, respectively). Conclusions: In patients with syndrome X, the impairment in cardiac MIBG uptake was associated with a reduction in HRV indexes mainly reflecting vagal modulation of sinus node, thus suggesting that a predominance of cardiac adrenergic activity may be present in those with abnormal cardiac MIBG scintigraphy.",
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T1 - Relationship between myocardial 123I-metaiodobenzylguanidine scintigraphic uptake and heart rate variability in patients with syndrome X

AU - Lanza, G. A.

AU - Giordano, A.

AU - Pristipino, C.

AU - Calcagni, M. L.

AU - Meduri, G.

AU - Trani, C.

AU - Franceschini, R.

AU - Crea, F.

AU - Troncone, L.

PY - 2000

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N2 - Background: We have recently demonstrated a striking impairment in cardiac uptake of 123I-metaiodobenzylguanidine (MIBG) in most patients with syndrome X. In this study we investigated the relationship between cardiac MIBG defects and cardiac autonomic activity in these patients. Methods: MIBG myocardial scintigraphy and time-domain and frequency-domain heart rate variability (HRV) were compared in 11 syndrome X patients and 10 healthy controls. Cardiac MIBG uptake was assessed by the heart/mediastinum ratio and a cardiac MIBG uptake defect score (higher values = lower uptake). Results: The heart/mediastinum ratio was lower (1.71 ± 0.6 vs 2.19 ± 0.3, p = 0.03) and MIBG uptake score higher (37.1 ± 32 vs 4.0 ± 2.5, p = 0.005) in syndrome X patients, whereas average HRV values did not differ between the two groups. However, while there were no correlations between MIBG uptake and HRV in controls, in syndrome X patients both the heart/mediastinum ratio and MIBG uptake score correlated significantly with two HRV parameters, specific for vagal activity: the square root of the mean squared differences of consecutive RR intervals (r = 0.73, p = 0.01, and r = -0.67, p = 0.02, respectively), and high frequency (r = 0.64, p = 0.03, and r = -0.74, p = 0.009, respectively). Conclusions: In patients with syndrome X, the impairment in cardiac MIBG uptake was associated with a reduction in HRV indexes mainly reflecting vagal modulation of sinus node, thus suggesting that a predominance of cardiac adrenergic activity may be present in those with abnormal cardiac MIBG scintigraphy.

AB - Background: We have recently demonstrated a striking impairment in cardiac uptake of 123I-metaiodobenzylguanidine (MIBG) in most patients with syndrome X. In this study we investigated the relationship between cardiac MIBG defects and cardiac autonomic activity in these patients. Methods: MIBG myocardial scintigraphy and time-domain and frequency-domain heart rate variability (HRV) were compared in 11 syndrome X patients and 10 healthy controls. Cardiac MIBG uptake was assessed by the heart/mediastinum ratio and a cardiac MIBG uptake defect score (higher values = lower uptake). Results: The heart/mediastinum ratio was lower (1.71 ± 0.6 vs 2.19 ± 0.3, p = 0.03) and MIBG uptake score higher (37.1 ± 32 vs 4.0 ± 2.5, p = 0.005) in syndrome X patients, whereas average HRV values did not differ between the two groups. However, while there were no correlations between MIBG uptake and HRV in controls, in syndrome X patients both the heart/mediastinum ratio and MIBG uptake score correlated significantly with two HRV parameters, specific for vagal activity: the square root of the mean squared differences of consecutive RR intervals (r = 0.73, p = 0.01, and r = -0.67, p = 0.02, respectively), and high frequency (r = 0.64, p = 0.03, and r = -0.74, p = 0.009, respectively). Conclusions: In patients with syndrome X, the impairment in cardiac MIBG uptake was associated with a reduction in HRV indexes mainly reflecting vagal modulation of sinus node, thus suggesting that a predominance of cardiac adrenergic activity may be present in those with abnormal cardiac MIBG scintigraphy.

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