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Myocardial sympathetic innervation (MSI) in coronary artery disease (CAD): Follow-up after one year without cardiac intervention

¹ Institute of Radiology, Nuclear Medicine and Molecular Imaging; ² Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany

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Objectives: In both diabetics and non-diabetics, a slight correlation exists between coronary flow reserve (CFR) and MSI in viable myocardial segments. This implies that MSI can be preserved even if there is major impairment of CFR. Anyhow, in some patients denervation is observed due to repetitive episodes of ischemia in areas with severely reduced CFR. We investigated the long-term effect of restrictions in CFR on MSI.

Methods: We analyzed 10 diabetics and 13 non-diabetics with advanced CAD. At baseline, we determined CFR (N-13-ammonia), viability (F-18-FDG) and MSI (C-11-HED). A one year follow-up study was performed including CFR and HED retention. During the follow-up, no cardiac intervention was performed and none of the patients suffered from myocardial infarction.

Results: There was no significant difference in segmental HED retention between baseline and follow-up in the whole patient group. In diabetics, HED retention showed a small but significant decrease (p = 0.007). Same was true for segments with severely reduced CFR (< 1.5) (p = 0.0009). Linear regression of segmental HED retention between baseline and follow-up study was high (r2 = 0.81), confirming good reproducibility of the investigation on the one hand and little change in MSI on the other hand.

Conclusions: In absence of cardiac interventions or myocardial infarctions, there is little change in MSI in both diabetics and non-diabetics in a one year follow-up. In myocardial segments with severely altered CFR, small but significant decrease in HED retention most probably reflects ischemic neuronal damage.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Fricke, E. Articles by Burchert, W. PubMed Articles by Fricke, E. Articles by Burchert, W.