Evidence for regional catecholamine uptake and storage sites in the transplanted human heart by positron emission tomography

• Published in: The Journal of clinical investigation Vol. 87; no. 5; pp. 1681 - 1690
• Main Authors: Schwaiger, M, Hutchins, G D, Kalff, V, Rosenspire, K, Haka, M S, Mallette, S, Deeb, G M, Abrams, G D, Wieland, D
• Format: Journal Article
• Language: English
• Published: Ann Arbor, MI American Society for Clinical Investigation 01.05.1991
• Subjects: 550601 - Medicine- Unsealed Radionuclides in Diagnostics; ALKALI METAL ISOTOPES; ALKALOIDS; AMINES; ANIMALS; AROMATICS; AUTONOMIC NERVOUS SYSTEM; AUTONOMIC NERVOUS SYSTEM AGENTS; BETA DECAY RADIOISOTOPES; BETA-PLUS DECAY RADIOISOTOPES; Biological and medical sciences; BLOOD FLOW; BLOOD PRESSURE; Blood Pressure - drug effects; BODY; CARBON 11; CARBON ISOTOPES; Carbon Radioisotopes; CARDIOVASCULAR AGENTS; CARDIOVASCULAR SYSTEM; CATECHOLAMINES; Catecholamines - metabolism; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DRUGS; ELECTRON CAPTURE RADIOISOTOPES; EMISSION COMPUTED TOMOGRAPHY; EPHEDRINE; Ephedrine - analogs & derivatives; Ephedrine - pharmacology; EVEN-ODD NUCLEI; HEART; Heart - innervation; Heart Transplantation; HOURS LIVING RADIOISOTOPES; Humans; HYDROXY COMPOUNDS; INTERMEDIATE MASS NUCLEI; Investigative techniques, diagnostic techniques (general aspects); ISOTOPES; LIGHT NUCLEI; Male; MAMMALS; MAN; Medical sciences; MINUTES LIVING RADIOISOTOPES; Myocardium - metabolism; Myocardium - pathology; NERVES; NERVOUS SYSTEM; NUCLEI; ODD-ODD NUCLEI; ORGANIC COMPOUNDS; ORGANS; PATIENTS; PHENOLS; POLYPHENOLS; POSITRON COMPUTED TOMOGRAPHY; PRIMATES; RADIOISOTOPES; RADIOLOGY AND NUCLEAR MEDICINE; Radionuclide investigations; RUBIDIUM 82; RUBIDIUM ISOTOPES; Sympathetic Nervous System - metabolism; SYMPATHOMIMETICS; TOMOGRAPHY; Tomography, Emission-Computed; transplantation; TRANSPLANTS; UPTAKE; VASOCONSTRICTORS; VERTEBRATES; Heart; Radionuclide study; Storage; Innervation; Transplantation; Catecholamine; Positron emission tomography; Uptake; Positron
• ISSN: 0021-9738; 1558-8238
• DOI: 10.1172/JCI115185

Positron emission tomography in combination with the newly introduced catecholamine analogue [11C]hydroxyephedrine ([11C]HED) enables the noninvasive delineation of sympathetic nerve terminals of the heart. To address the ongoing controversy over possible reinnervation of the human transplant, 5 healthy control subjects and 11 patients were studied after cardiac transplant by this imaging approach. Regional [11C]HED retention was compared to regional blood flow as assessed by rubidium-82. Transplant patients were divided into two groups. Group I had recent (less than 1 yr, 4.4 +/- 2.3 mo) surgery, while group II patients underwent cardiac transplantation more than 2 yr before imaging (3.5 +/- 1.3 yr). [11C]HED retention paralleled blood flow in normals, but was homogeneously reduced in group I. In contrast, group II patients revealed heterogeneous [11C]HED retention, with increased uptake in the proximal anterior and septal wall. Quantitative evaluation of [11C]HED retention revealed a 70% reduction in group I and 59% reduction in group II patients (P less than 0.001). In group II patients, [11C]HED retention reached 60% of normal in the proximal anterior wall. These data suggest the presence of neuronal tissue in the transplanted human heart, which may reflect regional sympathetic reinnervation.