Noninvasive detection of cardiac sympathetic nervous dysfunction in diabetic patients using [123I]metaiodobenzylguanidine

• Published in: Diabetes (New York, N.Y.) Vol. 41; no. 9; pp. 1069 - 1075
• Main Authors: MÄNTYSAARI, M, KUIKKA, J, MUSTONEN, J, TAHVANAINEN, K, VANNINEN, E, LÄNSIMIES, E, UUSITUPA, M
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.09.1992
• Subjects: 3-Iodobenzylguanidine; Autonomic Nervous System - physiology; Biological and medical sciences; Catecholamines - blood; Diabetes Mellitus - physiopathology; Diabetic Neuropathies - blood; Diabetic Neuropathies - diagnosis; Diabetic Neuropathies - physiopathology; Endocrinopathies; Heart Rate - physiology; Humans; Injections, Intravenous; Iodine Radioisotopes; Iodobenzenes - administration & dosage; Iodobenzenes - analysis; Isometric Contraction - physiology; Male; Medical sciences; Middle Aged; Myocardium - chemistry; Myocardium - metabolism; Sympathetic Nervous System - physiology; Sympatholytics - administration & dosage; Sympatholytics - analysis; Heart; Endocrinopathy; Radionuclide study; Human; Nervous system diseases; Diabetes mellitus; Diseases of the autonomic nervous system; Myocardium; Circulatory system; Neuropathy; Sympathic nervous system
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/diab.41.9.1069

The association between clinical autonomic dysfunction and myocardial MIBG accumulation was investigated. The study groups comprised 6 male diabetic patients with autonomic neuropathy (ANP+ group), 6 male diabetic patients without autonomic neuropathy (ANP-group), and 6 male nondiabetic control subjects. The mean age was comparable in all groups, and the subjects had no evidence of coronary heart disease. Reduced heart-rate variation in a deep-breathing test was used as a criterion for autonomic neuropathy. Immediately after injection, the peak net influx rate of MIBG to myocardium was significantly (P less than 0.05) reduced in both diabetic groups. At 6 hr after MIBG injection, the MIBG uptake of the myocardium was significantly (P less than 0.05) smaller in the ANP+ group than in the control group. In the ANP- group, the MIBG uptake of the myocardium was between that of the ANP+ group and that of the control group. Our data show that reduced myocardial MIBG accumulation is associated with autonomic dysfunction in diabetic patients, but it can occur to a lesser extent also in diabetic patients without apparent autonomic neuropathy. The measurement of the myocardial MIBG accumulation is a promising new method to detect cardiac sympathetic nervous dysfunction in diabetic patients.