Review ArticleVolume 13, Issue 4, April 2020
JOURNAL:JACC: Cardiovascular Imaging Article Link
Nuclear Imaging of the Cardiac Sympathetic Nervous System: A Disease-Specific Interpretation in Heart Failure
JGE Zelt, RA deKemp, BH Rotstein et al.
Keywords:
positron emissions tomography; sympathetic nervous system; sympathetic nervous system radioisotopes
ABSTRACT
Abnormalities in the cardiac sympathetic nervous system have been
documented in various heart diseases and have been directly implicated
in their pathogenesis and disease progression. Noninvasive techniques
using single-photon-emitting radiotracers for planar scintigraphy and
single-photon emission computed tomography, and positron-emitting
tracers for positron emissions tomography, have been used to
characterize the cardiac sympathetic nervous system with norepinephrine
analogs [123I]meta-iodobenzylguanidine for planar and single-photon emission computed tomography imaging and [11C]meta-hydroxyephedrine
for positron emissions tomography. Their usefulness in prognostication
and risk stratification for cardiac events has been demonstrated. This
review bridges basic and clinical research and focuses on applying an
understanding of tracer kinetics and neuronal biology, to aid in the
interpretation of nuclear imaging of cardiac sympathetic innervation.