{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:53:18Z","timestamp":1787017998261,"version":"build-2736575974"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1997,8,5]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    Previous studies have suggested that an abnormal cardiac adrenergic tone may have a pathophysiological role in syndrome X (effort angina, positive exercise testing, angiographically normal coronary arteries).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    To evaluate cardiac adrenergic nerve function, we performed [\n                    <jats:sup>123<\/jats:sup>\n                    I]metaiodobenzylguanidine (MIBG) myocardial scintigraphy in 12 patients with syndrome X and 10 control subjects. Cardiac MIBG uptake was assessed by the heart\/mediastinum (H\/M) ratio and by an MIBG uptake defect score (higher values=lower uptake). In syndrome X patients, we also correlated MIBG scintigraphic findings with stress myocardial perfusion as assessed by\n                    <jats:sup>201<\/jats:sup>\n                    Tl scintigraphy. An inferior MIBG defect was observed in only 1 control subject, whereas 9 patients (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.01) showed MIBG defects. The heart was totally or almost totally invisible on MIBG images in 5 patients, and predominantly regional defects were observed in 4. The H\/M ratio was lower (1.70\u00b10.6 versus 2.2\u00b10.3,\n                    <jats:italic>P<\/jats:italic>\n                    =.03) and MIBG uptake defect score higher (35\u00b131 versus 4\u00b12,\n                    <jats:italic>P<\/jats:italic>\n                    =.003) in syndrome X patients. Reversible stress thallium perfusion defects were found in 62% of patients with MIBG defects but in no patient with normal MIBG uptake. MIBG defects persisted unchanged in 7 patients at a 5\u00b13-month follow-up study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    In this study, obvious defects in global and\/or regional cardiac MIBG uptake, indicating an abnormal cardiac adrenergic nerve function, were detected in 75% of patients with syndrome X. These findings strongly support the cardiac origin of chest pain in syndrome X, although the mechanisms and the pathophysiological meaning of the abnormal cardiac MIBG uptake in these patients deserve further investigation.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.96.3.821","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:41:02Z","timestamp":1339447262000},"page":"821-826","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":117,"title":["Abnormal Cardiac Adrenergic Nerve Function in Patients With Syndrome X Detected By [\n                    <sup>123<\/sup>\n                    I]Metaiodobenzylguanidine Myocardial Scintigraphy"],"prefix":"10.1161","volume":"96","author":[{"given":"Gaetano Antonio","family":"Lanza","sequence":"first","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Giordano","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Pristipino","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lucia","family":"Calcagni","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Meduri","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Trani","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Franceschini","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Crea","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Troncone","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attilio","family":"Maseri","sequence":"additional","affiliation":[{"name":"From the Istituto di Cardiologia (G.A.L., C.P., C.T., F.C., A.M.) and Istituto di Medicina Nucleare (A.G., M.L.C., G.M., L.T.), Universita\u0300 Cattolica del Sacro Cuore, Rome, and Sorin Biomedia Diagnostics (R.F.), Saluggia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"735","volume":"54","year":"1973","unstructured":"Kemp HG, Vokonas PS, Cohn PF, Gorlin R. 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