SPECT imaging of cardioneuronal dysfunction

A growing body of evidence supports the use of cardiac sympathetic innervation imaging to risk stratify patients with heart failure, in particular by using cardiac [123I]metaiodobenzylguanidine (123I-MIBG) single photon emission CT (SPECT) imaging. Cardiac sympathetic imaging can help to improve understanding of the mechanisms responsible for increased sympathetic activity in heart failure, and how sympathetic overactivity exerts its deleterious actions, which may result in better therapy and outcome for patients with heart failure. Assessment of cardiac sympathetic activity would also contribute to more appropriate use of implantable cardioverter defibrillator and may help predict and prevent further lethal cardiac episodes. In addition, cardiac sympathetic imaging is also helpful in the clinical classification of patients with parkinsonian syndrome. Cardiac 123I-MIBG SPECT imaging allows early distinction between patients with Parkinson's disease or Lewy body dementia from those with Alzheimer's disease or other types of dementia who do not present with impaired cardiac sympathetic activity. © 2009 Springer.