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Journal of Nuclear Cardiology
Published in: Journal of Nuclear Cardiology 4/2019

Open Access 01-08-2019 | Original Article

Early therapeutic effects of adaptive servo-ventilation on cardiac sympathetic nervous function in patients with heart failure evaluated using a combination of 11C-HED PET and 123I-MIBG SPECT

Authors: Yusuke Tokuda, MD, Mamoru Sakakibara, MD, PhD, Keiichiro Yoshinaga, MD, PhD, FACC, FASNC, Shiro Yamada, MD, PhD, Kiwamu Kamiya, MD, PhD, Naoya Asakawa, MD, PhD, Takashi Yoshitani, MD, PhD, Keiji Noguchi, MD, PhD, Osamu Manabe, MD, PhD, Nagara Tamaki, MD, PhD, Hiroyuki Tsutsui, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 4/2019

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Abstract

Rationale

Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF.

Methods

We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57.3 ± 17.3 years old, left ventricular ejection fraction (LVEF) 36.1 ± 16.7%]. We performed echocardiography, polysomnography, biomarkers, 11C-hydroxyephedrine (HED) PET as a presynaptic function marker and planar 123I-metaiodobenzylguanidine (MIBG) to evaluate washout rate.

Results

ASV therapy reduced apnea-hypopnea index (AHI) and improved plasma brain natriuretic peptide (BNP) concentration. In 123I-MIBG imaging, the early heart/mediastinum (H/M) ratio increased after ASV therapy (2.19 ± 0.58 to 2.40 ± 0.67; P = 0.045). Washout rate did not change (23.8 ± 7.3% to 23.8 ± 8.8%; P = 0.122). Global 11C-HED retention index (RI) improved from 0.068 ± 0.033/s to 0.075 ± 0.034/s (P = 0.029).

Conclusions

ASV reduced AHI and improved BNP. ASV might initially improve presynaptic cardiac sympathetic nervous function in HF patients after 6 months of treatment.
Appendix
Available only for authorised users
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Metadata
Title
Early therapeutic effects of adaptive servo-ventilation on cardiac sympathetic nervous function in patients with heart failure evaluated using a combination of 11C-HED PET and 123I-MIBG SPECT
Authors
Yusuke Tokuda, MD
Mamoru Sakakibara, MD, PhD
Keiichiro Yoshinaga, MD, PhD, FACC, FASNC
Shiro Yamada, MD, PhD
Kiwamu Kamiya, MD, PhD
Naoya Asakawa, MD, PhD
Takashi Yoshitani, MD, PhD
Keiji Noguchi, MD, PhD
Osamu Manabe, MD, PhD
Nagara Tamaki, MD, PhD
Hiroyuki Tsutsui, MD, PhD
Publication date
01-08-2019
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 4/2019
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-017-1132-4

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