Transcatheter Aortic Valve Implantation Improves Cardiac Sympathetic Nerve Activity on <sup>123</sup>I-Metaiodobenzylguanidine Myocardial Scintigraphy in Severe Aortic Valve Stenosis

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  • Sobajima Mitsuo
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
  • Ueno Hiroshi
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
  • Onoda Hiroshi
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
  • Kuwahara Hiroyuki
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
  • Tanaka Shuhei
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
  • Ushijima Ryuichi
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
  • Fukuda Nobuyuki
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
  • Yokoyama Shigeki
    The First Department of Surgery, Graduate School of Medicine, University of Toyama
  • Nagura Saori
    The First Department of Surgery, Graduate School of Medicine, University of Toyama
  • Doi Toshio
    The First Department of Surgery, Graduate School of Medicine, University of Toyama
  • Yamashita Akio
    The First Department of Surgery, Graduate School of Medicine, University of Toyama
  • Fukahara Kazuaki
    The First Department of Surgery, Graduate School of Medicine, University of Toyama
  • Ito Hisakatsu
    The Department of Anesthesiology, Graduate School of Medicine, University of Toyama
  • Kinugawa Koichiro
    The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama

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Other Title
  • Transcatheter Aortic Valve Implantation Improves Cardiac Sympathetic Nerve Activity on ¹²³I-Metaiodobenzylguanidine Myocardial Scintigraphy in Severe Aortic Valve Stenosis

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<p>Background:There is a consensus that overactivation of the cardiac sympathetic nervous system (CSN) proportionately increases the severity of heart failure and is accompanied by worse prognosis. Because it is unknown whether patients with aortic valve stenosis (AS) have similar CSN activation, we investigated the effect of transcatheter aortic valve implantation (TAVI).</p><p>Methods and Results:We enrolled 31 consecutive patients with AS treated by TAVI. 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was performed at baseline and at 2 weeks after TAVI. At baseline, the early heart-mediastinum ratio (H/M) was within normal limits (3.0±0.5), but the delayed H/M was low (2.6±0.6) and the washout rate (WR) was high (34±13%). WR negatively correlated with aortic valve area (r=−0.389, P<0.01) and cardiac output (r=−0.595, P<0.01) and positively correlated with norepinephrine (r=0.519, P<0.01) and log NT-proBNP level (r=0.613, P<0.01). After TAVI, there were significant decreases in the norepinephrine level (366±179 ng/mL vs. 276±125 ng/mL, P<0.01) and WR (34±13 vs. 26±11%, P<0.01).</p><p>Conclusions:The WR of MIBG was a useful marker of CSN activity and severity of AS. Immediate improvement of CSN activity after TAVI implied that AS hemodynamics per se enhanced CSN.</p>

Journal

  • Circulation Journal

    Circulation Journal 82 (2), 579-585, 2018

    The Japanese Circulation Society

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