Anger recall mental stress decreases 123 I-metaiodobenzylguanidine ( 123 I-MIBG) uptake and increases heterogeneity of c
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Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT Nuclear Cardiology Laboratory, Yale-New Haven Hospital, New Haven, CT Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT Department of Biomedical Engineering, Yale University School of Medicine, New Haven, CT Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan
Received Jan 8, 2020; Revised Aug 28, 2020; accepted Aug 31, 2020 doi:10.1007/s12350-020-02372-1
Background. Acute psychological stressors such as anger can precipitate ventricular arrhythmias, but the mechanism is incompletely understood. Quantification of regional myocardial sympathetic activity with 123I-metaiodobenzylguanidine (123I-mIBG) SPECT imaging in conjunction with perfusion imaging during mental stress may identify a mismatch between perfusion and sympathetic activity that may exacerbate a mismatch between perfusion and sympathetic activity that could create a milieu of increased vulnerability to ventricular arrhythmia. Methods. Five men with ischemic cardiomyopathy (ICM), and five age-matched healthy male controls underwent serial 123I-mIBG and 99mTc-Tetrofosmin SPECT/CT imaging during an anger recall mental stress task and dual isotope imaging was repeated approximately 1 week later during rest. Images were reconstructed using an iterative reconstruction algorithm with CT-based attenuation correction. The mismatch of left ventricular myocardial 123I-mIBG and 99m Tc-Tetrofosmin was assessed along with radiotracer heterogeneity and the 123I-mIBG heartto-mediastinal ratios (HMR) were calculated using custom software developed at Yale.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02372-1) contains supplementary material, which is available to authorized users. Ricardo Avendan˜o and Taraneh Hashemi-Zonouz have contributed equally to this work. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com. The authors have also provided an audio summary of the article, which isavailable to download as ESM, or to listen to via the JNC/ ASNCPodcast. Funding: This work was supported in part by two Investigator Initiated Trial Grants from General Electric Healthcare, Inc. (M150714,
Lampert13-MIBG-004Grants, Lampert & Liu), two Grant-in-Aid research grants from the American Heart Association (13GRNT17090037 Chi Liu and 14GRNT19040010, Y-H Liu), NIH R01 Grant (R01 HL084438, Burg), and NIH T32 training Grant (HL098069, Sinusas). No other potential conflict of interest relevant to this article was reported. Reprint requests: Yi-Hwa Liu, PhD, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, Dana 3, PO Box 208017, New Haven, CT 06520-8017; [email protected]
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