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Clinical significance of scintigraphic difference between heart failure and parkinsonism in patients with severe decreased 123I-MIBG myocardial uptake Yoshiteru Abe 1 1Division of Nuclear Medicine Yaizu City Hospital Keyword: 123I-MIBG心筋シンチグラフィ , 心不全 , パーキンソニズム pp.1123-1134
Published Date 2020/9/10
DOI https://doi.org/10.18888/rp.0000001389
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Recently. 123I-metaiodobenzylguanidine(MIBG)myocardial scintigraphy has been used to evaluate patients not only with heart failure but also parkinsonism.

We performed MIBG myocardial scintigraphy to observe the difference between two entities in 167 patients with severe decreased MIBG uptake(heart to mediastinum ratio:H/M less than 1.6). We considered these patients have severely reduced sympathetic nerve function in both entities. We divided these patients into heart failure group(65 patients)and parkinsonism group(102 patients)and compared MIBG indices obtained from heart, thyroid, and lung.

Early H/M(p=0.014), delayed H/M(p<0.001), early thyroid mediastinum ratio(p=0.020), and delayed thyroid mediastinum ratio(p=0.047)were more reduced in patients with parkinsonism than heart failure. Heart washout rate(p<0.001)and thyroid washout rate(p<0.001)were more increased in patients with parkinsonism than heart failure. These indices suggested sympathetic nerve function were more severely reduced in patients with parkinsonism than heart failure. Delayed lung mediastinum ratio(p=0.027)was more increased in patients with parkinsonism but early lung mediastinum ratio(p<0.001)was more increased in patients with heart failure. Thus, the clinical significance of MIBG lung uptake was unclear and needed further investigation.

Severe declined sympathetic nerve function in patients with parkinsonism than heart failure in MIBG indices may be caused by the different damage mechanisms between catecholamine drive induced by heart failure and nerve cell degeneration or omission of cell itself suffered from Lewy body disease.


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電子版ISSN 印刷版ISSN 0009-9252 金原出版

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