6-[F-18]fluorodopamine positron emission tomographic scanning in the assessment of cardiac sympathoneural function

Thoracic positron emission tomographic (PET) scanning after injection of 6-[F-18]fluorodopamine ([F-18]-6F-DA) visualizes cardiac sympathetic innervation We tested whether changes in curves relating myocardial [F-18]-6F-DA-derived radioactivity with time (time-activity curves, TACs) can reflect changes in important aspects of cardiac sympathetic function. Thoracic PET scans were obtained after intravenous administration of [F-18]-6F-DA or the perfusion imaging agent [N-13]ammonia into normal volunteers. Ganglion blockade with trimethaphan (TRI) was used to decrease sympathoneural traffic, desipramine (DMI) to block neuronal uptake of catecholamines, and tyramine (TYR) to displace vesicular amines. After [F-18]-6F-DA administration, myocardial concentrations of [F-18]-6F-DA-derived radioactivity declined bi-exponentially from the peak value. TRI increased the y-intercept (y(o)) value for the early phase (p = 0.01), and DMI decreased the y(o) for the late phase (p = 0.01). The TRI effect did not result from increased arterial [F-18]-6F-DA concentrations or from increased myocardial perfusion. TYR infusion, begun 90 min after [F-18]-6F-DA administration, accelerated the decline of myocardial radioactivity by 2.6-fold (p = 0.003). Alterations in post-ganglionic sympathoneural traffic, neuronal catecholamine uptake, and vesicular turnover of monoamines produce distinct changes in myocardial TACs after [F-18]-6F-DA injection. [F-18]-6F-DA PET scanning may therefore enable assessments of effects of stressors, drugs, and neurocardiological disorders on specific aspects of cardiac sympathoneural function.