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Titolo:
Recovery of the cardiac adrenergic nervous system after long-term beta-blocker therapy in idiopathic dilated cardiomyopathy: Assessment by increase in myocardial I-123-metaiodobenzylguanidine uptake
Autore:
Lotze, U; Kaepplinger, S; Kober, A; Richartz, BM; Gottschild, D; Figulla, HR;
Indirizzi:
Univ Jena, Dept Internal Med Cardiol Angiol & Intens Care Me, D-6900 Jena,Germany Univ Jena Jena Germany D-6900 giol & Intens Care Me, D-6900 Jena,Germany Univ Jena, Dept Nucl Med, D-6900 Jena, Germany Univ Jena Jena Germany D-6900 Jena, Dept Nucl Med, D-6900 Jena, Germany
Titolo Testata:
JOURNAL OF NUCLEAR MEDICINE
fascicolo: 1, volume: 42, anno: 2001,
pagine: 49 - 54
SICI:
0161-5505(200101)42:1<49:ROTCAN>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONGESTIVE-HEART-FAILURE; FAILING HUMAN HEART; SYMPATHETIC ACTIVITY; PLASMA NOREPINEPHRINE; RECEPTOR DENSITY; RATE-VARIABILITY; DOWN-REGULATION; METAIODOBENZYLGUANIDINE; METOPROLOL; CARVEDILOL;
Keywords:
cardiac adrenergic activity; I-123-MIBG; idiopathic; dilated cardiomyopathy; beta-blocker therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Lotze, U Klinikum Friedrich Schiller Univ, Erlanger Allee 101, D-07740 Jena, Germany Klinikum Friedrich Schiller Univ Erlanger Allee 101 Jena Germany D-07740
Citazione:
U. Lotze et al., "Recovery of the cardiac adrenergic nervous system after long-term beta-blocker therapy in idiopathic dilated cardiomyopathy: Assessment by increase in myocardial I-123-metaiodobenzylguanidine uptake", J NUCL MED, 42(1), 2001, pp. 49-54

Abstract

In chronic heart failure, elevated plasma norepinephrine (NE) levels and adisparity between the neuronal release and the effective reuptake of NE lead to an increased concentration of NE in the presynaptic cleft, causing a downregulation of the myocardial beta -adrenoceptors. The clinical and prognostic effectiveness of beta -blocker therapy has been shown in patients with chronic heart failure in several large trials. The purpose of this studywas to investigate the effect of long-term beta -blocker therapy on the cardiac adrenergic nervous system as assessed by the myocardial uptake of I-123-metaiodobenzylguanidine (MIBG), an analog of NE, in idiopathic dilated cardiomyopathy (IDC). Methods: in 10 patients with [DC and stable chronic heart failure the myocardial MIBG uptake was measured at baseline and at 1 y (median, 11.5 mo) after treatment with beta -blockers (metoprolol, n = 5; bisoprolol, n = 1; and carvedilol, n = 4) in addition to standard medication. In parallel with the changes in MIBG uptake, the New York Heart Association functional class, the left ventricular ejection fraction (LVEF), and theleft ventricular end-diastolic diameter (LVEDD) were documented before andafter 1 y of therapy with beta -blockers. Results: During the 1-y follow-up, a significant increase in myocardial I-123-MIBG uptake (P = 0.005) in parallel with an improved LVEF (P = 0.005) and a reduced LVEDD (P = 0.019) was found. A trend toward an improvement of the New York Heart Association functional class under the beta -blocker therapy (P = 0.139) was also found. Conclusion: Assessment of the myocardial I-123-MIBG uptake is a useful noninvasive tool for evaluating changes in cardiac sympathetic nerve activity under medical therapy. Long-term treatment with beta -blockers in IDC causesa recovery of the cardiac adrenergic nervous system concomitantly with a clinical and hemodynamic improvement.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 22:46:48