Effects of cardiac sympathetic nervous system on the stunned myocardium experimental study with 123I-metaiodobenzylguanidine.

123I-Metaiodobenzylguanidine (123I-MIBG) uptake in the stunned myocardium was investigated in open chest dogs. 123I-MIBG is a tracer taken up in presynaptic adrenergic vesicles and reflects the function of the myocardial sympathetic nervous system. This study revealed that in the stunned myocardium without infarct, 123I-MIBG uptake was normal up to 40 minutes of ischemia and that exogenous noradrenaline improved deteriorated regional wall motion with increased uptake of 123I-MIBG. However, uptake of 123I-MIBG per flow decreased with infarct in ischemic areas, and it showed a linear relation with regional wall motion. Thus, in the absence of infarction 123I-MIBG is a tracer to differentiate stunning from more severe ischemia with persistent wall motion abnormality. Normal uptake and storage of 123I-MIBG in the stunned condition suggests that catecholamine release or second effector mechanism may relate to the mechanism.