Circulation, Vol 82, 457-464, Copyright © 1990 by American Heart Association
M Schwaiger, V Kalff, K Rosenspire, MS Haka, E Molina, GD Hutchins, M Deeb, E Wolfe Jr and DM Wieland
The noninvasive functional characterization of the cardiac sympathetic
nervous system by imaging techniques may provide important
pathophysiological information in various cardiac disease states.
Hydroxyephedrine labeled with carbon 11 has been developed as a new
catecholamine analogue to be used in the in vivo evaluation of presynaptic
adrenergic nerve terminals by positron emission tomography (PET). To
determine the feasibility of this imaging approach in the human heart, six
normal volunteers and five patients with recent cardiac transplants
underwent dynamic PET imaging after intravenous injection of 20 mCi
[11C]hydroxyephedrine. Blood and myocardial tracer kinetics were assessed
using a regions-of-interest approach. In normal volunteers, blood 11C
activity cleared rapidly, whereas myocardium retained 11C activity with a
long tissue half-life. Relative tracer retention in the myocardium averaged
79 +/- 31% of peak activity at 60 minutes after tracer injection. The
heart-to-blood 11C activity ratio exceeded 6:1 as soon as 30 minutes after
tracer injection, yielding excellent image quality. Little regional
variation of tracer retention was observed, indicating homogeneous
sympathetic innervation throughout the left ventricle. In the transplant
recipients, myocardial [11C]hydroxyephedrine retention at 60 minutes was
significantly less (- 82%) than that of normal volunteers, indicating only
little non- neuronal binding of the tracer in the denervated human heart.
Thus, [11C]hydroxyephedrine, in combination with dynamic PET imaging,
allows the noninvasive delineation of myocardial adrenergic nerve
terminals. Tracer kinetic modeling may permit quantitative assessment of
myocardial catecholamine uptake, which will in turn provide insights into
the effects of various disease processes on the neuronal integrity of the
heart.
ARTICLES
Noninvasive evaluation of sympathetic nervous system in human heart by positron emission tomography
University of Michigan Medical Center, Department of Internal Medicine, Ann Arbor 48109-0028.
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