Cardiac sympathetic dysfunction correlates with abnormal myocardial contractile reserve in dilated cardiomyopathy patients

Satoru Ohshima, Satoshi Isobe, Hideo Izawa, Mamoru Nanasato, Akitada Ando, Akira Yamada, Kiyoyasu Yamada, Tomoko S. Kato, Koji Obata, Akiko Noda, Takao Nishizawa, Katsuhiko Kato, Kohzo Nagata, Kenji Okumura, Toyoaki Murohara, Mitsuhiro Yokota

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVES: We investigated the relationship between iodine-123- metaiodobenzylguanidine (123I-MIBG) findings and myocardial contractile reserve in patients with mild to moderate dilated cardiomyopathy (DCM). BACKGROUND: Little is known regarding the relationship between cardiac sympathetic nervous function and myocardial contractile reserve in DCM. METHODS: Twenty-four DCM patients who showed sinus rhythm underwent echocardiography, biventricular catheterization, and myocardial 123I-MIBG scintigraphy. Left ventricular (LV) pressures were measured using a micromanometer-tipped catheter. The myocardial contractile function (LV dP/dtmax) was determined at rest and during atrial pacing. The messenger ribonucleic acid (mRNA) expressions of intracellular Ca2+-regulatory proteins were analyzed by real-time quantitative reverse transcription-polymerase chain reaction. Myocardial 123I-MIBG accumulation was quantified as a heart-mediastinum ratio (HMR). RESULTS: A significant correlation was observed between the delayed 123I-MIBG HMR and the percentage change in LV dP/dtmax from the baseline to the peak or critical heart rate (r = 0.64; p < 0.001). The delayed 123I-MIBG HMR was significantly lower in patients showing a worsening change in LV dP/dtmax than in those showing a favorable change (p < 0.005). The maximum LV dP/dt max during pacing and the sarcoplasmic reticulum Ca 2+-ATPase (SERCA2) mRNA levels were significantly more reduced in patients with a delayed HMR ≤1.8 than in those with a delayed HMR >1.8 (p < 0.05, respectively). CONCLUSIONS: Abnormal myocardial 123I-MIBG accumulation is related to an impaired myocardial contractile reserve and down-regulation of SERCA2 mRNA in DCM. Myocardial 123I-MIBG scintigraphy can be useful in noninvasively evaluating myocardial contractile reserve in patients with mild to moderate DCM.

Original languageEnglish
Pages (from-to)2061-2068
Number of pages8
JournalJournal of the American College of Cardiology
Volume46
Issue number11
DOIs
Publication statusPublished - 06-12-2005

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Cardiac sympathetic dysfunction correlates with abnormal myocardial contractile reserve in dilated cardiomyopathy patients'. Together they form a unique fingerprint.

  • Cite this

    Ohshima, S., Isobe, S., Izawa, H., Nanasato, M., Ando, A., Yamada, A., Yamada, K., Kato, T. S., Obata, K., Noda, A., Nishizawa, T., Kato, K., Nagata, K., Okumura, K., Murohara, T., & Yokota, M. (2005). Cardiac sympathetic dysfunction correlates with abnormal myocardial contractile reserve in dilated cardiomyopathy patients. Journal of the American College of Cardiology, 46(11), 2061-2068. https://doi.org/10.1016/j.jacc.2005.08.046