Cardiac sympathetic dysfunction in haemodialysed patients

BACKGROUND: The aim of this study was to evaluate thecardiac sympathetic nervous system function in haemodialysed(HD), non-diabetic patients by iodine-123 meta-iodo-benzylguanidine(123I-mIBG). MATERIALS AND METHODS: Planar scintigraphy of the chestwas performed in 36 HD, male patients; 15 minutes and 4 hourspost injection of 370 MBq of 123I-mIBG. The semiquantitativeanalysis of myocardial tracer uptake was expressed as routineheart to mediastinum (H/M) ratio: 15 minutes (early H/M) and4 hour (late H/M) post administration as well as washout of thetracer from myocardium (WR). 24-hour Holter studies were recordedand heart rate variability (HRV) was evaluated. Patientswere divided into two groups according to the H/M value: groupA patients with H/M > 1.8 which has been accepted as a norm,and group B patients with H/M < 1.8. RESULTS: In 21/36 patients H/M ratio was below normal values.Significant differences between groups A and B were foundamong the following parameters: early H/M and late H/M ratios,WR and duration of haemodialysis therapy. CONCLUSIONS: In patients with abnormal function of cardiacsympathetic nervous system, expressed by means of H/M ratiobelow 1.8, duration of haemodialysis treatment was longer.Duration of HD appears to be an important factor influencingcardiac sympathetic nervous system.