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Jung YW, Gu G, Raffel DM. Improved synthesis of 4-[ 18 F]fluoro-m-hydroxyphenethylguanidine using an iodonium ylide precursor. J Labelled Comp Radiopharm 2019; 62:835-842. [PMID: 31361048 DOI: 10.1002/jlcr.3791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 11/11/2022]
Abstract
Fluorine-18 labeled hydroxyphenethylguanidines were recently developed in our laboratory as a new class of PET radiopharmaceuticals for quantifying regional cardiac sympathetic nerve density in heart disease patients. Studies of 4-[18 F]fluoro-m-hydroxyphenethylguanidine ([18 F]4F-MHPG) and 3-[18 F]fluoro-p-hydroxyphenethylguanidine ([18 F]3F-PHPG) in human subjects have shown that these radiotracers can be used to generate high-resolution maps of regional sympathetic nerve density using the Patlak graphical method. Previously, these compounds were synthesized using iodonium salt precursors, which provided sufficient radiochemical yields for on-site clinical PET studies. However, we were interested in exploring new methods that could offer significantly higher radiochemical yields. Spirocyclic iodonium ylide precursors have recently been established as an attractive new approach to radiofluorination of electron-rich aromatic compounds, offering several advantages over iodonium salt precursors. The goal of this study was to prepare a spirocyclic iodonium ylide precursor for synthesizing [18 F]4F-MHPG and evaluate its efficacy in production of this radiopharmaceutical. Under optimized automated reaction conditions, the iodonium ylide precursor provided radiochemical yields averaging 7.8% ± 1.4% (n = 8, EOS, not decay corrected), around threefold higher than those achieved previously using an iodonium salt precursor. With further optimization and scale-up, this approach could potentially support commercial distribution of [18 F]4F-MHPG to PET centers without on-site radiochemistry facilities.
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Affiliation(s)
- Yong-Woon Jung
- Division of Nuclear Medicine, Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Guie Gu
- Division of Nuclear Medicine, Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - David M Raffel
- Division of Nuclear Medicine, Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Zumhagen S, Vrachimis A, Stegger L, Kies P, Wenning C, Ernsting M, Müller J, Seebohm G, Paul M, Schäfers K, Stallmeyer B, Schäfers M, Schulze-Bahr E. Impact of presynaptic sympathetic imbalance in long-QT syndrome by positron emission tomography. Heart 2017; 104:332-339. [PMID: 28864717 DOI: 10.1136/heartjnl-2017-311667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/27/2017] [Accepted: 07/31/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We investigated the impact of cardiac presynaptic norepinephrine recycling in patients with long-QT syndrome (LQTS) using positron emission tomography (PET) with 11C-meta-hydroxyephedrine ([11C]mHED-PET). METHODS [11C]mHED-PET was performed in 25 patients with LQTS (LQT1: n=14; LQT2: n=11) and 20 healthy controls and correlated with clinical parameters. [11C]mHED-PET images were analysed for global and regional retention indices (RI) and washout rates (WO) reflecting dynamic parameters of the tracer activity. RESULTS Global and regional RI values were similar between patients with LQTS and controls. Although the global WO rates were similar between these groups, regional WO rates were on average higher in the lateral left ventricle (LV) wall in patients with LQTS (dose, mean ±SD; 0.08±0.14 vs 0.00%±0.09% min-1; p=0.033). In addition, patients with LQTS with a longer QTc interval showed a higher global WO rate. Clinical symptoms correlated with higher global WO rates. In the presence of normal global WO rates, asymptomatic LQTS patients showed higher global RI values. CONCLUSION The increased regional WO rate of [11C]mHED in the lateral LV suggests an imbalance of presynaptic catecholamine reuptake and release, resulting in a higher synaptic catecholamine concentration, in particular in LQT1 patients. This might enhance β-adrenoceptor signalling and thereby aggravate inherited ion channel dysfunction and may facilitate occurrence of ventricular tachyarrhythmias. Detection of regional differences in LV sympathetic nervous function may modify disease expression and potentially serve as a non-invasive risk marker in congenital LQTS. TRIAL REGISTRATION NUMBER 2006-002767-41;Results.
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Affiliation(s)
- Sven Zumhagen
- Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany
| | - Alexis Vrachimis
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Lars Stegger
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Peter Kies
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Christian Wenning
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Marko Ernsting
- Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany.,Interdisciplinary Center for Clinical Research (IZKF), University Hospital Münster, Münster, Germany
| | - Jovanca Müller
- Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany
| | - Guiscard Seebohm
- Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany
| | - Matthias Paul
- Division of Cardiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany
| | - Klaus Schäfers
- European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany.,DFG EXC 1003 Cluster of Excellence `Cells in Motion´, University of Münster, Münster, Germany
| | - Birgit Stallmeyer
- Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany.,DFG EXC 1003 Cluster of Excellence `Cells in Motion´, University of Münster, Münster, Germany
| | - Eric Schulze-Bahr
- Department of Cardiovascular Medicine, Institute for Genetics of Heart Diseases (IfGH), University Hospital Münster, Münster, Germany.,Interdisciplinary Center for Clinical Research (IZKF), University Hospital Münster, Münster, Germany
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Paolillo S, Rengo G, Pellegrino T, Formisano R, Pagano G, Gargiulo P, Savarese G, Carotenuto R, Petraglia L, Rapacciuolo A, Perrino C, Piscitelli S, Attena E, Del Guercio L, Leosco D, Trimarco B, Cuocolo A, Perrone-Filardi P. Insulin resistance is associated with impaired cardiac sympathetic innervation in patients with heart failure. Eur Heart J Cardiovasc Imaging 2015; 16:1148-53. [PMID: 25845954 DOI: 10.1093/ehjci/jev061] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 02/24/2015] [Indexed: 01/07/2023] Open
Abstract
AIMS Insulin resistance (IR) represents, at the same time, cause and consequence of heart failure (HF) and affects prognosis in HF patients, but pathophysiological mechanisms remain unclear. Hyperinsulinemia, which characterizes IR, enhances sympathetic drive, and it can be hypothesized that IR is associated with impaired cardiac sympathetic innervation in HF. Yet, this hypothesis has never been investigated. Aim of the present observational study was to assess the relationship between IR and cardiac sympathetic innervation in non-diabetic HF patients. METHODS AND RESULTS One hundred and fifteen patients (87% males; 65 ± 11.3 years) with severe-to-moderate HF (ejection fraction 32.5 ± 9.1%) underwent iodine-123 meta-iodobenzylguanidine ((123)I-MIBG) myocardial scintigraphy to assess sympathetic innervation and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) evaluation to determine the presence of IR. From (123)I-MIBG imaging, early and late heart to mediastinum (H/M) ratios and washout rate were calculated. Seventy-two (63%) patients showed IR and 43 (37%) were non-IR. Early [1.68 (IQR 1.53-1.85) vs. 1.79 (IQR 1.66-1.95); P = 0.05] and late H/M ratio [1.50 (IQR 1.35-1.69) vs. 1.65 (IQR 1.40-1.85); P = 0.020] were significantly reduced in IR compared with non-IR patients. Early and late H/M ratio showed significant inverse correlation with fasting insulinemia and HOMA-IR. CONCLUSION Cardiac sympathetic innervation is more impaired in patients with IR and HF compared with matched non-IR patients. These findings shed light on the relationship among IR, HF, and cardiac sympathetic nervous system. Additional studies are needed to clarify the pathogenetic relationship between IR and HF.
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Affiliation(s)
- S Paolillo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - G Rengo
- Division of Cardiology, "Salvatore Maugeri" Foundation-IRCCS-Institute of Telese Terme (BN), Italy Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - T Pellegrino
- Department of Advanced Biomedical Sciences, Section of Imaging, Radiotherapy, Neuroradiology and Medical Physics, Federico II University, Naples, Italy Institute of Biostructures and Bioimages of the National Council of Research, Naples, Italy
| | - R Formisano
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - G Pagano
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - P Gargiulo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
| | - G Savarese
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - R Carotenuto
- Department of Advanced Biomedical Sciences, Section of Imaging, Radiotherapy, Neuroradiology and Medical Physics, Federico II University, Naples, Italy
| | - L Petraglia
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - A Rapacciuolo
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - C Perrino
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - S Piscitelli
- Department of Translational Medical Sciences, Section of Clinical Pathology, Federico II University, Naples, Italy
| | - E Attena
- Department of Cardiology Fatebenefratelli Hospital, Naples, Italy
| | - L Del Guercio
- Department of Public Health, Federico II University, Naples, Italy
| | - D Leosco
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - B Trimarco
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - A Cuocolo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy Department of Advanced Biomedical Sciences, Section of Imaging, Radiotherapy, Neuroradiology and Medical Physics, Federico II University, Naples, Italy
| | - P Perrone-Filardi
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
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