Regional myocardial sympathetic dysinnervation in patients with coronary vasospasm

Hajime Takano, Takamichi Nakamura, Takeshi Satou, Ken Umetani, Akinori Watanabe, Tsukasa Ishihara, Sunao Mochizuki, Hideaki Kimura, Hajime Honma, Yoshio Ikeda, Kiyoshi Koizumi, Ali S. Arbab, Kohji Tamura

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


The purpose of this study was to assess the presence and location of impaired myocardial sympathetic innervation by using 123I metaiodobenzylguanidine (123I MIBG) in 15 patients with coronary vasospasm induced by intracoronary acetylcholine. The results were compared with those using thallium-201 (Tl-201). We also examined 14 patients with severe coronary stenosis (>90%) and 8 control subjects without significant coronary stenosis (<50%) and provokable coronary vasospasm. Regional myocardial sympathetic dysinnervation was detected by 123I MIBG single-photon emission computed tomography (SPECT) in all patients with coronary vasospasm, despite normal uptake during Tl-201 SPECT. This regional uptake-mismatch between 123I MIBG and Tl-201 SPECT occurred specifically in the vasospasm group (p < 0.001 vs stenosis and control groups). Moreover, regional myocardial sympathetic dysinnervation was located in the distribution of perfusion in 25 of the 27 vasospasm-induced vessels. Normal uptake of 123I MIBG was observed in the perfused areas in 16 of the 18 non-vasospasm-induced vessels. The sensitivity and specificity of 123I MIBG for detection of coronary vasospasm were 92% and 88%, respectively. In patients with coronary vasospasm, we found regional myocardial sympathetic dysinnervation to be present. Furthermore, we were able to distinguish these patients from patients with critical coronary stenosis by 123I MIBG and Tl-201 SPECT.

Original languageEnglish (US)
Pages (from-to)324-329
Number of pages6
JournalThe American Journal of Cardiology
Issue number5-6
StatePublished - Feb 15 1995
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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