Functional neuroimaging of sympathetic innervation of the heart

Annals of the New York Academy of Sciences
David S Goldstein

Abstract

Many concepts about acute and chronic effects of stress depend on alterations in sympathetic nerves supplying the heart. Physiologic, pharmacologic, and neurochemical approaches have been used to evaluate cardiac sympathetic function. This article describes a fourth approach that is based on nuclear scanning to visualize cardiac sympathetic innervation and function and relationships between the neuroimaging findings and those from other approaches. Multiple-system atrophy with orthostatic hypotension (formerly the Shy-Drager syndrome) features normal cardiac sympathetic innervation and normal entry of norepinephrine into the coronary sinus (cardiac norepinephrine spillover), in contrast to Parkinson disease with orthostatic hypotension, which features neuroimaging and neurochemical evidence for loss of cardiac sympathetic nerves. This difference may have important implications not only for diagnosis but also for understanding the etiology of Parkinson disease. By analysis of curves relating myocardial radioactivity with time (time-activity curves) after injection of a sympathoneural imaging agent, it is possible to obtain information about cardiac sympathetic function. Abnormal time-activity curves are seen in common disorders ...Continue Reading

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Citations

May 6, 2010·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Axel BuobM Böhm
Feb 8, 2008·The New England Journal of Medicine·Roy Freeman
Nov 21, 2008·Autonomic Neuroscience : Basic & Clinical·Wohaib Hasan, Peter G Smith
Dec 20, 2008·Journal of the American College of Cardiology·Roland von Känel
Dec 17, 2016·Expert Review of Neurotherapeutics·Stefano Caproni, Carlo Colosimo
Mar 11, 2016·British Journal of Hospital Medicine·Baljit K UpadhyayAkeem Sule

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