Details

Autor(en) / Beteiligte

• Rasmussen, Thorsten K.
• Borghammer, Per
• Finnerup, Nanna B.
• Jensen, Troels S.
• Hansen, John
• Knudsen, Karoline
• Singer, Wolfgang
• Lamotte, Guillaume
• Terkelsen, Astrid J.

Titel

Functional and 123I-MIBG scintigraphy assessment of cardiac adrenergic dysfunction in diabetes

Ist Teil von

• Autonomic neuroscience, 2024-04, Vol.252, p.103155-103155, Article 103155

Ort / Verlag

Elsevier B.V

Erscheinungsjahr

2024

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• To assess the agreement between clinical cardiovascular adrenergic function and cardiac adrenergic innervation in type 2 diabetes patients (T2D). Thirty-three patients with T2D were investigated bimodally through (1) a standardized clinical cardiovascular adrenergic assessment, evaluating adequacy of blood pressure responses to the Valsalva maneuver and (2) 123I-meta-iodobenzylguanidine (MIBG) scintigraphy assessing myocardial adrenergic innervation measured as early and delayed heart heart/mediastinum (H/M) ratio, and washout rate (WR). T2D patients had significantly lower early and delayed H/M-ratios, and lower WR, compared to laboratory specific reference values. Thirteen patients had an abnormal adrenergic composite autonomic severity score (CASS > 0). Patients with abnormal CASS scores had significantly higher early H/M ratios (1.76 [1.66–1.88] vs. 1.57 [1.49–1.63], p < 0.001), higher delayed H/M ratios (1.64 [1.51:1.73] vs. 1.51 [1.40:1.61] (p = 0.02)), and lower WR (−0.13(0.10) vs −0.05(0.07), p = 0.01). Lower Total Recovery and shorter Pressure Recovery Time responses from the Valsalva maneuver was significantly correlated to lower H/M early (r = 0.55, p = 0.001 and r = 0.5, p = 0.003, respectively) and lower WR for Total Recovery (r = −0.44, p = 0.01). The present study found impairment of sympathetic innervation in T2D patients based on parameters derived from MIBG cardiac scintigraphy (low early H/M, delayed H/M, and WR). These results confirm prior studies. We found a mechanistically inverted relationship with favourable adrenergic cardiovascular responses being significantly associated unfavourable MIBG indices for H/M early and delayed. This paradoxical relationship needs to be further explored but could indicate adrenergic hypersensitivity in cardiac sympathetic denervated T2D patients. •Patients with type 2 diabetes have impaired cardiac sympathetic innervation.•Preserved cardiovascular reflex response is associated with sympathetic denervation.•MIBG scintigraphy allows for assessment of cardiac autonomic innervation integrity.