Abnormal Myocardial Adrenergic Nerve Function in Orthostatic Hypotension

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Abstract

A 70-year-old man had frequent syncope and faintness when in an upright position. A diagnosis of primary orthostatic hypotension was obtained by a head-up tilt test and various autonomic nerve function tests. No abnormalities were seen on myocardium scintigraphy using <sup>201</sup>Tl. However, <sup>123</sup>I-metaiodobenzyl-guanidine did not accumulate in the heart. This suggests that globally denervated myocardium may impair a prompt increase in cardiac contractility and fail to maintain cerebral blood flow, thereby contributing to postural hypotension in this disorder.

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A radiological analysis of heart sympathetic functions with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failure.

Shigetaka Hakusui, Takeshi Yasuda, Tsutomu Yanagi … (1994)

Cardiac scintigraphy with meta-[123I]iodobenzylguanidine (MIBG) is used to assess cardiac sympathetic function. We performed [123I]MIBG scintigraphy in 7 patients with neurological diseases presenting orthostatic hypotension and other autonomic failures (AF), 22 neurological patients without AF, and 9 healthy subjects. Thallium scintigraphy and echocardiography were also performed in all subjects. In this series, patients with any evidence of cardiac dysfunction were excluded. No [123I]MIBG accumulation was observed in all patients with AF, and cardiac defects were noted in 7 patients (5 with Parkinson's disease [PD], 2 with spinocerebellar degenerations [SCD]), and in some patients without AF. In contrast, the distribution of [123I]MIBG was normal in all the healthy subjects. No decrease in [123I]MIBG accumulation was resulted from drug therapy (droxidopa, amezinium and thyrotropin-releasing hormone). In conclusion, reduced accumulation on [123I]MIBG scintigraphy may be due to myocardial beta-adrenoceptor dysfunction or reduced central sympathetic activity of the heart, or both.

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Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 1998

Publication date (Print): December 1998

Publication date (Electronic): 15 October 2008

Volume: 90

Issue: 3

Pages: 236-238

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Second Department of Internal Medicine, Iwate Medical University, Morioka, Japan

Article

Publisher ID: 6850 Other ID: Cardiology 1998;90:236–238

DOI: 10.1159/000006850

PubMed ID: 9892775

SO-VID: 0f811858-2689-4343-96ca-967f0467a319

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Abnormal Myocardial Adrenergic Nerve Function in Orthostatic Hypotension

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Karger: Cardiovascular System

Most cited references 1

A radiological analysis of heart sympathetic functions with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failure.

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