Diagnostic and prognostic imaging of the cardiac sympathetic nervous system

Jeanne Link, James H. Caldwell

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Individuals with systolic dysfunction congestive heart failure may have decreased neuronal density, decreased neuronal function (reuptake or retention of norepinephrine), or a combination of these, plus reduction in postsynaptic β-receptor density. Cardiac neuronal distribution and function can be imaged with standard γ cameras and PET using radiolabeled analogs of norepinephrine. Postsynaptic β-adrenergic receptor distribution and density can be determined using PET. Multiple imaging studies of the presynaptic component have reported that those individuals with the lowest retention or fastest washout of the radiolabeled analogs have a much greater annual mortality than do those with greater retention or slower washout rate. The results of some studies have suggested that the image abnormalities are better predictors of death than are more common predictors of outcome such as ejection fraction, heart rate variability, and microvolt T-wave alternans. The variability between these studies makes it unclear which measure of presynaptic dysfunction is the most predictive. β-Receptor imaging has not been evaluated as extensively as a prognostic tool as has presynaptic imaging. Preliminary data suggest that regional mismatch between β-receptors and presynaptic norepinephrine transporter function may serve as a marker for adverse outcome.

Original languageEnglish (US)
JournalNature Clinical Practice Cardiovascular Medicine
Volume5
Issue numberSUPPL. 2
DOIs
StatePublished - Aug 2008
Externally publishedYes

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Sympathetic Nervous System
Diagnostic Imaging
Norepinephrine
Norepinephrine Plasma Membrane Transport Proteins
Presynaptic Receptors
Post-Synaptic Density
Adrenergic Receptors
Heart Failure
Heart Rate
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Diagnostic and prognostic imaging of the cardiac sympathetic nervous system. / Link, Jeanne; Caldwell, James H.

In: Nature Clinical Practice Cardiovascular Medicine, Vol. 5, No. SUPPL. 2, 08.2008.

Research output: Contribution to journalArticle

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