Imágenes de inervación miocárdica: MIBG en práctica clínica

Autores/as

DOI:

https://doi.org/10.54502/msuceva.v2n2a3

Palabras clave:

Imágenes, inervación cardíaca, insuficiencia cardíaca, función simpática, MIBG

Resumen

La 123I-metayodobencilguanidina (MIBG) es un análogo de norepinefrina radiomarcado que se puede usar para investigar la inervación simpática del miocardio. La gammagrafía con 123I-MIBG se ha investigado con interés en muchos contextos patológicos. En pacientes con insuficiencia cardiaca (IC) sistólica, la gammagrafía con 123I-MIBG puede detectar el deterioro funcional y la rarefacción de las terminales simpáticas (que se manifiestan como reducción de la relación corazón-mediastino [H/M] temprana y tardía en la gammagrafía planar) y aumento del flujo de salida simpático (que puede visualizarse como una alta tasa de lavado). Estos hallazgos se han asociado consistentemente con un peor resultado: más notablemente, un ensayo de fase 3, encontró que los pacientes con un H/M tardío 1.60, poseen una mayor incidencia de mortalidad cardiovascular y por todas las causas y arritmias potencialmente mortales durante un seguimiento de menos de 2 años. A pesar de estos hallazgos prometedores, la gammagrafía con 123I-MIBG aún no ha sido recomendada por las principales guías de IC como una herramienta para la estratificación del riesgo aditivo y nunca ha entrado en la etapa de adopción generalizada en la práctica clínica actual. La gammagrafía con 123I-MIBG también se ha evaluado en pacientes con infarto de miocardio, trastornos genéticos caracterizados por una mayor susceptibilidad a las arritmias ventriculares y varias otras condiciones caracterizadas por alteración de la inervación miocárdica simpática. En la presente revisión, se resumirá el estado del arte de la gammagrafía cardíaca con 123I-MIBG, los problemas actuales sin resolver y las posibles direcciones de la investigación futura.

 

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Biografía del autor/a

Alberto Aimo , Cardiology Division, University Hospital of Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy

Cardiólogo en la Fondazione Toscana Gabriele Monasterio (una sección del Consejo Nacional de Investigación de Italia) y candidato a doctorado en la Scuola Superiore Sant'Anna en Pisa, Italia. Su actividad investigadora se ha centrado principalmente en la insuficiencia cardiaca y los miocardios en particular, la miocardiopatía dilatada idiopática y la amiloidosis cardiaca, pero también la afectación cardiaca en la enfermedad mitocondrial o las distrofias musculares. Sus principales campos de interés son el uso de biomarcadores o hallazgos de imagen como herramientas para el diagnóstico y manejo de la insuficiencia cardíaca y las miocardiopatías.

Alessia Gimelli, Fondazione Toscana Gabriele Monasterio, Pisa, Italy

Directora Médica. Departamento de Medicina Nuclear en la Fondazione Toscana/CNR"Gabriele Monasterio", Pisa, Italia. Ha publicado más de 150 artículos publicados en revistas indexadas en Scopus y WoS. Es editora actualmente de cuatro revistas Q1 y Q2: Imaging, European Journal of Cardiovascular Imaging; Journal of Nuclear Cardiology; International Journal of Cardiac Imaging. Es cardióloga y especialista en medicina nuclear. Desde 2013, lidera el sistema de aseguramiento de la calidad del departamento de medicina nuclear de la FTGM. En octubre de 2019 ganó la beca ESC: Women Transforming Leadership Program (WTLP) de la Saïd Business School de la Universidad de Oxford (Reino Unido). Tiene una amplia experiencia en investigación clínica sobre enfermedades cardiovasculares e imágenes cardiovasculares y ha contribuido a varios proyectos internacionales de alto perfil. Es miembro del Comité de Defensa de ESC (2020-2022) y fue vicepresidente de EACVI y presidente de la sección de cardiología nuclear y TC (2018-2020).

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Publicado

2022-12-01

Cómo citar

1.
Aimo A, Gimelli A. Imágenes de inervación miocárdica: MIBG en práctica clínica. Magna Sci. UCEVA [Internet]. 1 de diciembre de 2022 [citado 22 de noviembre de 2024];2(2):177-90. Disponible en: http://revistas.uceva.edu.co/index.php/magnascientia/article/view/48

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Medicina (Medicine)

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