Reappearance of cardiac presynaptic sympathetic nerve terminals in the transplanted heart: Correlation between PET using 11C-hydroxyephedrine and invasively measured norepinephrine release

K. Odaka, W. Von Scheidt, S. I. Ziegler, P. Ueberfuhr, S. G. Nekolla, B. Reichart, F. M. Bengel, M. Schwaiger

Research output: Contribution to journalArticlepeer-review

Abstract

Previously, sympathetic reinnervation of the transplanted heart has been described using invasive catheterization techniques and noninvasive radionuclide imaging techniques. However, little is known about the agreement between these 2 methods. Thus, correlation between 11C-hydroxyephedrine (HED) PET and invasively measured norepinephrine (NE) release was investigated in transplant recipients in this study, Methods: Using PET and the catecholamine analog HED, 17 patients were studied between 2 mo and 13.6 y after transplantation. Based on results in completely denervated hearts, areas with HED retention >7%/min were defined as reinnervated. Additionally, transcardiac NE release induced by intravenous tyramine (55 uμg/kg) was measured by coronary sinus and aortic catheterization within 1 wk of the PET study. NE levels between coronary sinus and aortic root, ΔNECS-Ao, were calculated at baseline and after tyramine administration. Differences of more than 3 SD of baseline (>163 pg/mL) were interpreted as reinnervation. Results: HED retention indicated reinnervation in 10 patients. Maximal HED retention ranged from 4.3%/min to 16.4%/min./-ΔNECS-Ao 1 min after tyramine administration ranged between -10 pg/mL and 1157 pg/mL, and 8 patients were above the reinnervation threshold. Fisher's exact test demonstrated good agreement between results of PET and ANECS-Ao measurements (P = 0.002). Maximal HED retention was also significantly correlated with NE release (r = 0.69; P = 0.001). Conclusion: Results of invasively measured NE release and noninvasive 11C-HED PET are well correlated. This study further supports the usefulness of PET as a noninvasive approach for detection of reappearance of catecholamine uptake sites after heart transplantation.

Original languageEnglish (US)
Pages (from-to)1011-1016
Number of pages6
JournalJournal of Nuclear Medicine
Volume42
Issue number7
StatePublished - 2001
Externally publishedYes

Keywords

  • C-hydroxy-ephedrine
  • Heart transplantation
  • Norepinephrine
  • PET
  • Sympathetic reinnervation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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