Usefulness of impairment of cardiac adrenergic nerve function to predict outcome in patients with cardiac syndrome X

Antonio Di Monaco, Gaetano Antonio Lanza, Isabella Bruno, Giulia Careri, Gaetano Pinnacchio, Pierpaolo Tarzia, Irma Battipaglia, Alessandro Giordano, Filippo Crea

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with cardiac syndrome X (CSX) have an excellent long-term prognosis, but a significant number show worsening angina over time. Previous studies have found a significant impairment of cardiac uptake of iodine-123-meta-iodobenzylguanidine (MIBG) on myocardial scintigraphy, indicating abnormal function of cardiac adrenergic nerve fibers. The aim of this study was to assess whether cardiac MIBG results can predict symptomatic outcome in patients with CSX. Cardiac MIBG scintigraphy was performed in 40 patients with CSX (mean age 58 ± 5 years, 14 men). Cardiac MIBG uptake was measured by the heart/mediastinum uptake ratio and a single photon-emission computed tomographic regional uptake score (higher values reflected lower uptake). Clinical findings, exercise stress test parameters, sestamibi stress myocardial scintigraphy, and C-reactive protein serum levels were also assessed. At an average follow-up of 79 months (range 36 to 144), no patient had died or developed acute myocardial infarction. Cardiac MIBG defect score was significantly lower in patients with worsening versus those without worsening of angina status (13 ± 7 vs 38 ± 28, p = 0.001), in those with versus those without hospital readmission because of recurrent chest pain (15 ± 9 vs 35 ± 29, p = 0.01), and in those who underwent versus those who did not undergo repeat coronary angiography (11 ± 7 vs 36 ± 27, p = 0.001). Significant correlations were found between quality of life (as assessed by the EuroQoL scale) and heart/mediastinum ratio (r = 0.48, p = 0.002) and cardiac MIBG uptake score (r = -0.69, p

Original languageEnglish
Pages (from-to)1813-1818
Number of pages6
JournalThe American Journal of Cardiology
Volume106
Issue number12
DOIs
Publication statusPublished - Dec 15 2010

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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