並列タイトル等Impairment of iodine-123-metaiodobenzylguanidine (123I-MIBG) uptake in patients with pulmonary artery hypertension
タイトル（掲載誌）International Heart Journal
学位博士(医学)
Doctor of Philosophy in Medical Science
一般注記博士論文全文, 最終試験結果の要旨, 論文審査の要旨, 博士論文要旨
According to recent studies, lung uptake of iodine-123-metaiodobenzylguanidine (123I-MIBG) is impaired in many lung diseases and low lung uptake of 123I-MIBG suggests endothelial dysfunction of the pulmonary artery.123I-MIBG scintigraphy in patients with pulmonary hypertension (PH) has not yet been clinically evaluated. We hypothesized that the lung uptake of 123I-MIBG is reduced in patients with PH and differs among PH subtypes. The purpose of the present study was to analyze the lung uptake of 123I-MIBG in patients with PH and compare it with the data obtained by echocardiography or right heart catheterization. 123I-MIBG scintigraphy was performed in 286 consecutive patients from 2003 to 2014. We enrolled 21 patients with PH and 8 control patients.The 21 patients with PH were categorized into those with pulmonary artery hypertension(PAH, n=12) and those with chronic thromboembolic pulmonary hypertension (CTEPH, n=9). The mean pulmonary artery pressure was not significantly different between patients with CTEPH and PAH (37.7 ± 6.8 versus 32.3 ± 5.3 mmHg respectively; P=0.054). There were no significant differences in any other hemodynamic parameters between the two groups.The lung uptake of 123I-MIBG in PAH patients (early image: 1.54 ± 0.18, delayed image: 1.41 ± 0.16) was significantly lower than that of CTEPH patients (early image: 2.17 ± 0.25,P<0.0001; delayed image: 1.99 ± 0.20, P=0.0001, adjusted for ageand World Health Organization classification) and controls(early image: 2.32 ± 0.27, P=0.0007; delayed image: 1.92 ± 0.19,P=0.0007). In conclusion, we found for the first time that the lung uptake of 123I-MIBG in patients with PAH is lower than that in patients with CTEPH and controls.
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