SCINTIGRAPHIC DETECTION OF REGIONAL DISRUPTION OF THE ADRENERGIC NERVOUS-SYSTEM IN SARCOID HEART-DISEASE

The presence of defects on resting thallium (Tl-201) myocardial scinti graphy has been previously demonstrated in myocardial sarcoidosis. To examine cardiac sympathetic nerve activity in patients with cardiac sa rcoidosis, we performed Tl-201 and I-123 MIBG (meta-iodobenzylguanidin e) myocardial scintigraphy in patients with sarcoidosis. Sixteen patie nts with sarcoidosis were classified into 2 groups according to the pr esence or absence of defects on Tl-201 scintigraphy. Myocardial images by both Tl-201 and I-123 MIBG were then divided into 20 segments and scored using a 6-point scoring system. Defect Score was defined as a t he sum of significant scores in each image. The mean Defect Score in I -123 MIBG images was higher in the Tl-201 defect group (44.3+/-13.3) t han in both the normal Tl-201 group (25.1+/-10.5) and the control grou p (22.7+/-11.4). Moreover, the locations of defects on I-123 MIBG scan s were consistent with those on Tl-201 scans. This study suggests that cardiac adrenergic function may be impaired in cardiac sarcoidosis, a nd I-123 MIBG scintigraphy may be more sensitive in detecting cardiac sarcoidosis than Tl-201 scintigraphy, although the clinical significan ce of these findings requires further study.