Cardiac Sympathetic Dysfunction In Haemodialysed Patients

BACKGROUND: The aim of this study was to evaluate the cardiac sympathetic nervous system function in haemodialysed (HD), non- diabetic patients by iodine-123 meta-iodo-benzylguanidine (I-123-mIBG).MATERIALS AND METHODS: Planar scintigraphy of the chest was performed in 36 HD, male patients; 15 minutes and 4 hours post injection of 370 MBq of I-123- mIBG. The semiquantitative analysis of myocardial tracer uptake was expressed as routine heart to mediastinum (H/M) ratio: 15 minutes (early H/M) and 4 hour (late H/M) post administration as well as washout of the tracer from myocardium (WR). 24- hour Holter studies were recorded and heart rate variability (HRV) was evaluated. Patients were divided into two groups according to the H/M value: group A 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 found among the following parameters: early H/M and late H/M ratios, WR and duration of haemodialysis therapy.CONCLUSIONS: In patients with abnormal function of cardiac sympathetic nervous system, expressed by means of H/M ratio below 1.8, duration of haemodialysis treatment was longer. Duration of HD appears to be an important factor influencing cardiac sympathetic nervous system.