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Published in: Journal of Nuclear Cardiology 4/2018

01-08-2018 | Original Article

Impact of an exercise training program on cardiac neuronal function in heart failure patients on optimal medical therapy

A randomized Iodine-123 metaiodobenzylguanidine scintigraphy study

Authors: Torstein Valborgland, MD, Kjetil Isaksen, MD, PhD, Peter Scott Munk, MD, PhD, Zbigniew Piotr Grabowski, MD, Alf Inge Larsen, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 4/2018

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Abstract

Background

The syndrome of heart failure (HF) is characterized by left ventricular dysfunction and a compensatory chronic over activation of the sympathetic nervous system. We wanted to investigate if the beneficial effects of exercise training (ET) in HF patients on optimal medical therapy (OMT) are associated with alterations in cardiac sympathetic activity.

Methods

Cardiac sympathetic activity was evaluated at baseline and after 12 weeks using metaiodobenzylguanidine scintigraphy in 23 patients with stable HF participating in the SmartEx trial. Patients with HF in New York Heart Association class II or III and left ventricular ejection fraction <35 % were randomized to three different ET groups.

Results

We found no statistically significant changes in cardiac sympathetic activity after 12 weeks of ET. Heart to mediastinum (H/M) ratio at 15 minutes (0.00174 ± 0.0841, P = 0.922), H/M ratio at 4 hours (−0.00565 ± 0.1163, P = 0.818) and washout ratio (WR) (−1.2666 ± 16.5412, P = 0.717). A further group-wise analysis of the three ET groups did not show any difference between the groups.

Conclusion

A 12-week ET program did not alter the abnormal cardiac sympathetic activity in stable HF patients on modern OMT.
Literature
1.
go back to reference Hasking GJ, Esler MD, Jennings GL, et al. Norepinephrine spillover to plasma in patients with congestive heart failure: evidence of increased overall and cardiorenal sympathetic nervous activity. Circulation. 1986;73:615–21. doi:10.1161/01.cir.73.4.615.CrossRefPubMed Hasking GJ, Esler MD, Jennings GL, et al. Norepinephrine spillover to plasma in patients with congestive heart failure: evidence of increased overall and cardiorenal sympathetic nervous activity. Circulation. 1986;73:615–21. doi:10.​1161/​01.​cir.​73.​4.​615.CrossRefPubMed
4.
6.
go back to reference Merlet P, Valette H, Dubois-Randé JL, et al. Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure. J Nucl Med. 1992;33:471–7.PubMed Merlet P, Valette H, Dubois-Randé JL, et al. Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure. J Nucl Med. 1992;33:471–7.PubMed
7.
go back to reference Hasking GJ, Esler MD, Jennings GL, et al. Norepinephrine spillover to plasma during steady-state supine bicycle exercise. Comparison of patients with congestive heart failure and normal subjects. Circulation. 1988;78:516–21. doi:10.1161/01.cir.78.3.516.CrossRefPubMed Hasking GJ, Esler MD, Jennings GL, et al. Norepinephrine spillover to plasma during steady-state supine bicycle exercise. Comparison of patients with congestive heart failure and normal subjects. Circulation. 1988;78:516–21. doi:10.​1161/​01.​cir.​78.​3.​516.CrossRefPubMed
8.
go back to reference Sato M, Maehara K, Yaoita H, et al. Correlation between cardiac norepinephrine overflow during exercise and cardiac 123I-MIBG uptake in patients with chronic heart failure. J Nucl Med. 2003;44:1618–24.PubMed Sato M, Maehara K, Yaoita H, et al. Correlation between cardiac norepinephrine overflow during exercise and cardiac 123I-MIBG uptake in patients with chronic heart failure. J Nucl Med. 2003;44:1618–24.PubMed
9.
go back to reference Agostini D, Lecluse E, Belin A, et al. Impact of exercise rehabilitation on cardiac neuronal function in heart failure: An iodine-123 metaiodobenzylguanidine scintigraphy study. Eur J Nucl Med. 1998;25:235–41. doi:10.1007/s002590050222.CrossRefPubMed Agostini D, Lecluse E, Belin A, et al. Impact of exercise rehabilitation on cardiac neuronal function in heart failure: An iodine-123 metaiodobenzylguanidine scintigraphy study. Eur J Nucl Med. 1998;25:235–41. doi:10.​1007/​s002590050222.CrossRefPubMed
10.
go back to reference Schofer J, Spielmann R, Schuchert A, et al. Iodine-123 meta-iodobenzylguanidine scintigraphy: A noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 1988;12:1252–8. doi:10.1016/0735-1097(88)92608-3.CrossRefPubMed Schofer J, Spielmann R, Schuchert A, et al. Iodine-123 meta-iodobenzylguanidine scintigraphy: A noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 1988;12:1252–8. doi:10.​1016/​0735-1097(88)92608-3.CrossRefPubMed
12.
go back to reference McMurray JJV, Adamopoulos S, Anker A-BSD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012;14:803–69. doi:10.1093/eurjhf/hfs105.CrossRefPubMed McMurray JJV, Adamopoulos S, Anker A-BSD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012;14:803–69. doi:10.​1093/​eurjhf/​hfs105.CrossRefPubMed
14.
go back to reference Haykowsky MJ, Liang Y, Pechter D, et al. A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients: The benefit depends on the type of training performed. J Am Coll Cardiol. 2007;49:2329–36. doi:10.1016/j.jacc.2007.02.055.CrossRefPubMed Haykowsky MJ, Liang Y, Pechter D, et al. A meta-analysis of the effect of exercise training on left ventricular remodeling in heart failure patients: The benefit depends on the type of training performed. J Am Coll Cardiol. 2007;49:2329–36. doi:10.​1016/​j.​jacc.​2007.​02.​055.CrossRefPubMed
16.
go back to reference Jacobson AF, Lombard J, Banerjee G, Camici PG. 123I-mIBG scintigraphy to predict risk for adverse cardiac outcomes in heart failure patients: Design of two prospective multicenter international trials. J Nucl Cardiol. 2008;16:113–21. doi:10.1007/s12350-008-9008-2.CrossRef Jacobson AF, Lombard J, Banerjee G, Camici PG. 123I-mIBG scintigraphy to predict risk for adverse cardiac outcomes in heart failure patients: Design of two prospective multicenter international trials. J Nucl Cardiol. 2008;16:113–21. doi:10.​1007/​s12350-008-9008-2.CrossRef
20.
go back to reference Agostini D, Belin A, Amar MH, et al. Improvement of cardiac neuronal function after carvedilol treatment in dilated cardiomyopathy: A 123I-MIBG scintigraphic study. J Nucl Med. 2000;41:845–51.PubMed Agostini D, Belin A, Amar MH, et al. Improvement of cardiac neuronal function after carvedilol treatment in dilated cardiomyopathy: A 123I-MIBG scintigraphic study. J Nucl Med. 2000;41:845–51.PubMed
21.
go back to reference Cohen-Solal A, Rouzet F, Berdeaux A, et al. Effects of carvedilol on myocardial sympathetic innervation in patients with chronic heart failure. J Nucl Med Off Publ Soc Nucl Med. 2005;46:1796–803. Cohen-Solal A, Rouzet F, Berdeaux A, et al. Effects of carvedilol on myocardial sympathetic innervation in patients with chronic heart failure. J Nucl Med Off Publ Soc Nucl Med. 2005;46:1796–803.
22.
go back to reference Takeishi Y, Atsumi H, Fujiwara S, et al. ACE inhibition reduces cardiac iodine-123-MIBG release in heart failure. J Nucl Med Off Publ Soc Nucl Med. 1997;38:1085–9. Takeishi Y, Atsumi H, Fujiwara S, et al. ACE inhibition reduces cardiac iodine-123-MIBG release in heart failure. J Nucl Med Off Publ Soc Nucl Med. 1997;38:1085–9.
23.
26.
go back to reference Verberne HJ, Verberne HJ, Brewster LM, et al. Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: A systematic review. Eur Heart J. 2008;29:1147–59. doi:10.1093/eurheartj/ehn113.CrossRefPubMed Verberne HJ, Verberne HJ, Brewster LM, et al. Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: A systematic review. Eur Heart J. 2008;29:1147–59. doi:10.​1093/​eurheartj/​ehn113.CrossRefPubMed
27.
go back to reference McMurray JJV, Adamopoulos S, Anker A-BSD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33:1787–847. doi:10.1093/eurheartj/ehs104.CrossRefPubMed McMurray JJV, Adamopoulos S, Anker A-BSD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33:1787–847. doi:10.​1093/​eurheartj/​ehs104.CrossRefPubMed
Metadata
Title
Impact of an exercise training program on cardiac neuronal function in heart failure patients on optimal medical therapy
A randomized Iodine-123 metaiodobenzylguanidine scintigraphy study
Authors
Torstein Valborgland, MD
Kjetil Isaksen, MD, PhD
Peter Scott Munk, MD, PhD
Zbigniew Piotr Grabowski, MD
Alf Inge Larsen, MD, PhD
Publication date
01-08-2018
Publisher
Springer US
Published in
Journal of Nuclear Cardiology / Issue 4/2018
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-016-0724-8

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