RADIONUCLIDE ASSESSMENT OF CARDIAC SYMPATHETIC ACTIVITY AND MYOCARDIAL PERFUSION IN PATIENTS WITH ATRIAL FIBRILLATION

DOI: https://doi.org/None

Yu.B. Lishmanov (1,2), Yu.V. Saushkina (1), S.M. Minin (1), I.Yu. Efimova (1), I.V. Kisteneva (1), S.V. Popov (1) 1 -Research Institute for Cardiology, Kievskaya str., 111a, Tomsk, Russian Federation, 634012; 2 -National Research Tomsk Polytechnic University, Pr. Lenina, 30, Tomsk, Russian Federation, 634050

Introduction. To date, the mechanisms underlying the majority of cardiac arrhythmias are unclear. The disturbance of sympathetic innervation of the heart may be as well the cause of atrial fibrillation (AF), as the reason of myocardial dysfunction of the left ventricle. The aim of the study. The assessment of cardiac sympathetic activity and myocardial perfusion in patients with atrial fibrillation by scintigraphy with 123I-metaiodbenzilguanidine (123I-MIBG) and 99mTc-MIBI, respectively. Methods. The study included 40 patients with suspected coronary artery disease, class 3 hypertension. All patients were divideв into 3 groups: 15 patients - with paroxysmal AF (PAF), 15 patients – with long-standing persistent AF (LSPAF) and 10 patients – with sinus rhythm (SR). All patients were underwent SPECT with 123I-MIBG and 99mTc-MIBI to evaluate of cardiac sympathetic activity and myocardial perfusion, respectively. Results. In both patients with PAF and LSPAF the early H/M ratio and delayed H/M ratio was significantly lower if compared to patients with SR. The washout rate of 123I-MIBG in both patients with PAF and LSPAF was greater if compared to patients with SR. However, both early and delayed SPECT images showed that the sympathetic activity defect was significantly more pronounceв in patients with LSPAF when compared to patients with PAF and patients with SR. Conclusions. The most sympathetic innervation abnormality was observed in patients with atrial fibrillation. The atrial fibrillation has no significant effect on myocardial perfusion. The most significant violation of the regional cardiac sympathetic activity was observed in patients with LSPAF.
Keywords: 
atrial fibrillation, 123I-MIBG, sympathetic innervation, 99mTc-MIBI
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