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-The sympathetic and parasympathetic nervous system -arrhythmogenic effects on the heart. Adapted from Franciosi et al. 17
Context in source publication
Context 1
... the heart, cardiac sympathetic and parasympathetic nervous systems (SNS) work by exerting essentially opposite responses. These branches differ in their neurotransmitters and use stimulatory or inhibitory effects on the target tissue through adrenergic and muscarinic receptors 2 ( Figure 1). ...
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Background
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Purpose
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Citations
... Nesse contexto, a imagem neuronal cardíaca pode ajudar no entendimento fisiopatológico, no diagnóstico e prognóstico dessas doenças. 3,4 No presente artigo, apresentamos de forma clara e objetiva o passo a passo da cintilografia com metaiodobenzilguanidina marcada com o iodo-123 (mIBG-I123) para avaliação da atividade simpática cardíaca nos principais cenários da prática clínica (Figura Central). O coração normal é densamente inervado pelo SNS, e a avaliação da atividade adrenérgica cardíaca de forma não invasiva é possível por meio da cintilografia cardíaca com mIBG-I123, um falso neurotransmissor análogo da guanetidina. ...
A inervação simpática desempenha um papel crucial na regulação do fluxo sanguíneo, cronotropismo, dromotropismo, lusitropismo e inotropismo miocárdico. Em várias doenças cardíacas e neurodegenerativas, observam se alterações no sistema nervoso autonômico. A imagem neuronal cardíaca pode ajudar no entendimento fisiopatológico, no diagnóstico e prognóstico dessas doenças. Neste artigo, apresentamos, de forma clara e objetiva, o passo a passo da cintilografia com mIBG-I123 para avaliação da atividade simpática cardíaca nos principais cenários da prática clínica.
... In such a context, cardiac neuronal imaging can aid in understanding the pathophysiology, diagnosis, and prognosis of these diseases. 3,4 This article provides a clear and objective overview of the step-by-step procedure for scintigraphy using metaiodobenzylguanidine labeled with iodine-123 (mIBG-I123) to assess cardiac sympathetic activity in the primary clinical practice scenarios (Central Illustration). DOI: https://doi.org/10.36660/abcimg.20240009i ...
... In addition, there is growing evidence that the use of scintigraphy in the evaluation of cardiac innervation can help in cardiovascular risk stratification, therapy selection, and evaluation of potential benefits of new therapeutic approaches. 3,4 However, there is increasing need for physicians with experience with this method, and hence, scientific studies that synthesize and discuss its applications, advantages, and disadvantages would contribute to the effective implementation in clinical practice. 5 In this issue, Brito et al. 4 present an interesting review on the use of scintigraphic imaging in the assessment of autonomic innervation in cardiac diseases. ...
... 3,4 However, there is increasing need for physicians with experience with this method, and hence, scientific studies that synthesize and discuss its applications, advantages, and disadvantages would contribute to the effective implementation in clinical practice. 5 In this issue, Brito et al. 4 present an interesting review on the use of scintigraphic imaging in the assessment of autonomic innervation in cardiac diseases. The article provides an overview of the use of nuclear medicine and different radiotracers in various clinical settings. ...
... Other applications include cardiovascular risk stratification in Chagas cardiomyopathy, hypertrophic cardiomyopathy, Takotsubo cardiomyopathy, early detection of cardiotoxicity, cardiac amyloidosis, and dysautonomia secondary to neurodegenerative diseases and diabetes mellitus, as well as therapeutical monitoring in several cardiac conditions. 4,5,11,12 In many of these situations, mapping of myocardial denervated areas can help in the identification of arrhythmogenic foci and prediction of arrhythmic events, 8 and consequently in better establishing patient risk and appropriate therapy. In addition, monitoring of recovery from myocardial injury by cardiac 123 I-mIBG scintigraphy helps in the evaluation of therapy effectiveness. 4 However, despite the well-established pathophysiological foundation and numerous studies supporting the benefits of scintigraphy in the evaluation of cardiac sympathetic activity, the scientific community still recommends the development of large prospective randomized clinical trials before including the method in clinical guidelines. ...
Hereditary transthyretin (TTR) amyloidosis, traditionally referred to as familial amyloid polyneuropathy, is an autosomal dominant multisystemic disease caused by the extracellular accumulation of abnormally misfolded TTR developing multiorgan failure. Autonomic manifestations are frequently reported in these patients. Among these, orthostatic symptoms resulting from cardiovascular autonomic dysfunctions significantly disturb daily life. Usual manifestations include symptoms of peripheral neuropathy, which may evolve into severe manifestations of generalized autonomic dysfunction, in addition to cardiological, neurological (peripheral sensory-motor polyneuropathy), visual, genitourinary, renal, and gastrointestinal symptoms. Early detection is extremely important, aiming for treatment and preventing progression.
