Journal of Cardiac Failure
Volume 16, Issue 9 , Pages 728-733, September 2010

Washout Rate of Cardiac Iodine-123 Metaiodobenzylguanidine is High in Chronic Heart Failure Patients With Central Sleep Apnea

  • Akira Tamura, MD

      Affiliations

    • Internal Medicine 2, Faculty of Medicine, Oita University, Yufu, Japan
    • Corresponding Author InformationReprint requests: Akira Tamura, MD, Internal Medicine 2, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu 879-5593, Japan. Tel: +81-(0)97-586-5804; Fax: +81-(0)97-549-4245.
    • ,
  • Shinichi Ando, MD, PhD

      Affiliations

    • Division of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital, Fukuoka, Japan
    • ,
  • Yukie Goto, MD

      Affiliations

    • Internal Medicine 2, Faculty of Medicine, Oita University, Yufu, Japan
    • ,
  • Yoshiyuki Kawano, MD

      Affiliations

    • Internal Medicine 2, Faculty of Medicine, Oita University, Yufu, Japan
    • ,
  • Kazuhiro Shinozaki, MD

      Affiliations

    • Internal Medicine 2, Faculty of Medicine, Oita University, Yufu, Japan
    • ,
  • Munenori Kotoku, MD

      Affiliations

    • Internal Medicine 2, Faculty of Medicine, Oita University, Yufu, Japan
    • ,
  • Junichi Kadota, MD, PhD

      Affiliations

    • Internal Medicine 2, Faculty of Medicine, Oita University, Yufu, Japan

Received 1 December 2009; received in revised form 15 April 2010; accepted 29 April 2010. published online 11 June 2010.

Abstract 

Background

The association between sleep-disordered breathing (SDB) assessed by polysomnography and cardiac sympathetic nerve activity (SNA) assessed by cardiac iodine-123 metaiodobenzylguanidine (123I-MIBG) imaging has not been investigated in patients with chronic heart failure (CHF).

Methods and Results

We performed cardiac 123I-MIBG scintigraphy and overnight polysomnography in 59 patients with stable CHF. The patients were classified into the 3 groups: 19 with no or mild SDB (NM-SDB, apnea-hypopnea index <15); 21 with central sleep apnea (CSA), and 19 with obstructive sleep apnea (OSA). The cardiac washout rate (WR) of 123I-MIBG was obtained from initial and delayed planar 123I-MIBG images. The WR was higher in patients with CSA (54.2 ± 11.6%) than in those with OSA (37.9 ± 8.6%, P < .05) or NM-SDB (40.8 ± 8.8%, P < .05). The WR correlated positively with central apnea index (ρ = 0.40, P = .002). A stepwise multiple regression analysis selected CSA and plasma brain natriuretic peptide levels as independent variables associated with the WR.

Conclusions

The WR was higher in CHF patients with CSA than in those with OSA or NM-SDB, and CSA was independently associated with the WR, suggesting a link of CSA to increased cardiac SNA in CHF.

Key Words: Iodine-123 metaiodobenzylguanidine, washout rate, sympathetic nerve activity, sleep-disordered breathing, central sleep apnea, obstructive sleep apnea, chronic heart failure

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 See page 732 for disclosure information.

PII: S1071-9164(10)00204-6

doi:10.1016/j.cardfail.2010.04.012

Journal of Cardiac Failure
Volume 16, Issue 9 , Pages 728-733, September 2010

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