Back to Search
Start Over
Cardiac sympathetic dysfunction in left ventricular hypertrophy caused by arterial hypertension and degenerative aortic stenosis.
- Source :
-
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2022 Feb; Vol. 29 (1), pp. 337-347. Date of Electronic Publication: 2020 Jul 01. - Publication Year :
- 2022
-
Abstract
- Background: To evaluate cardiac sympathetic innervation in hypertensive patients with left ventricular (LV) hypertrophy (H) and aortic stenosis (AS) submitted to transcatheter aortic valve implantation (TAVI).<br />Methods and Results: Twenty-two hypertensive elders (82 ± 5 years) with severe AS and significant LVH (> 122 g·m <superscript>-2</superscript> in women and > 149 g·m <superscript>-2</superscript> in men) were compared with 14 patients with uncomplicated essential hypertension (HT) with similar degree of LVH and 10 controls. <superscript>123</superscript> I-metaiodobenzylguanidine (MIBG) and <superscript>99m</superscript> Tc-tetrofosmin SPECT acquisitions were obtained to assess sympathetic innervation and LV perfusion. The innervation/perfusion mismatch score was taken as an indicator of cardiac sympathetic dysfunction. The imaging protocol was repeated 6 months after TAVI. Regional MIBG uptake was more heterogeneous in HT and AS patients than controls, and therefore, innervation/perfusion mismatch score was higher in both AS (9 ± 8) and HT (5 ± 2) than controls (1 ± 1, P < .001). On multivariate analysis, significant LVH was the major predictor of impaired LV sympathetic innervation (OR 19.45, 95% CI 1.87-201.92; P = .013). After TAVI, no differences in measures of LV sympathetic innervation were evident, although only a marginal LV mass reduction was observed (- 5.4 ± 2.4 g).<br />Conclusions: Cardiac sympathetic innervation is impaired in patients with LVH, either with AS or not, and is not impacted significantly by TAVI procedure.<br /> (© 2020. American Society of Nuclear Cardiology.)
Details
- Language :
- English
- ISSN :
- 1532-6551
- Volume :
- 29
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 32613476
- Full Text :
- https://doi.org/10.1007/s12350-020-02250-w