Rev. DERC (Online) 2021; 27(1): 56-61
Carditoxicity and the Potential Use of Cardiac Scan with 123I-MIBG
Abstract
Cardiotoxicity is an important complication associated with chemotherapy for the treatment of cancer patients. Its diagnosis is based on serial assessment of left ventricular ejection fraction (LVEF), however the LVEF decrease occurs late in the evolution of this condition. Thus, alternative non-invasive methods for early diagnosis of cardiotoxicity have emerged with this purpose, specially in echocardiography and nuclear medicine. The assessment of cardiac sympathetic function using 123I-MIBG scan arises as a promising tool, since adrenergic damage appears to precede structural cardiac damage. We have observed in some small studies that changes in the parameters of 123I-MIBG seem to occur in parallel with the deterioration of LVEF, with a decrease in the heart / mediastinum ratio (HMR) occurring earlier in some studies, when LVEF is still preserved. Therefore, the assessment of cardiac innervation seems to be a fertile field for future research in the scenario of cardiotoxicity.
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