Sympathetic nerve activity in the spasm-induced coronary artery region is associated with disease activity of vasospastic angina

Abstract

The MIBG washout rate of the spasm-induced coronary artery territory changed according to the degree of disease activity. Thus, sympathetic nerve activity could reflect disease activity of vasospastic angina.

Prognostic Value of I-123 Metaiodobenzylguanidine Imaging in Vasospastic Angina Without Significant Coronary Stenosis

“…15,18,20,[28][29][30][31][32] However, whether the sympathetic nervous system or parasympathetic nervous system has the dominant role in coronary vasospasm remains controversial. Sympathetic and parasympathetic imbalance 13 or overstimulation of receptors because of sympathetic overactivity with exercise 18 have been proposed as mechanisms responsible for exercise-induced coronary vasospasm.…”

“…In contrast, the role of the parasympathetic nervous system on the induction of coronary artery spasm has been demonstrated. [30][31][32] Using MIBG, as the reduced washout rate in VA becomes normal after intravenous atropine injection, 20 it has been suggested that the reduced washout rate reflects suppressed cardiac sympathetic activity caused by enhanced parasympathetic nervous activity. Because ischemic attacks caused by coronary artery spasm occur easily in VA patients with a reduced washout rate, the findings of the present study strongly support the hypothesis that enhanced parasympathetic activity is an important factor to the induction of coronary artery spasm leading to cardiac events.…”

“…More interestingly, the reduced washout rate was closely associated with disease activity. 20 Therefore, we consider that a reduced MIBG washout rate has prognostic value in VA.…”

Metaiodobenzylguanidine scintigraphy of cardiac sympathetic innervation

“…The testing results of MIBG-based examinations have been described for a variety of other heart diseases, including: primary arrhythmias [41][42][43], myocardial ischaemia with infarction [14][15][16][17] or without [44][45][46][47][48], in the assessment of the development of the innervation system after heart transplant [11,12,49], in the assessment of cardiotoxicity of anticancer chemotherapy [50][51][52]. There are also numerous reports showing that the I-123-MIBG imaging enables effective monitoring of the effects of conventional pharmacological therapies; images of MIBG uptake are improved after therapy with beta-blockers and often associated with reduced volume of the ventricles, better LVEF and reduced symptoms of heart failure; carvedilol has been most extensively researched in this respect (the recent randomised multi-centre double-blind placebo-controlled study was the French study described by showed that a damage of the myocardial adrenergic system can be responsible for the significant clinical improvement generally observed at an early stage after TMLR, however, in the light of reinnervation, it is not responsible for the improvement covering a period of several years [64][65][66][67].…”

Circadian Variation of Autonomic Nervous Activity in Patients With Multivessel Coronary Spasm

“…16 Although autonomic nervous activity is implicated, it is unclear whether multivessel spasm is associated with an abnormal circadian rhythm of autonomic nervous activity. Non-invasive techniques, such as HRV [3][4][5][6] and iodine-123 metaiodobenzylguanidine scintigraphy ( 123 I-MIBG) 17,18 have been used to investigate the role of autonomic nervous system in VA, so we analyzed the HRV in patients with coronary multivessel spasm to elucidate the relation between multivessel coronary spasm and the circadian rhythm of autonomic nervous activity.…”