The mechanism of chronotropic incompetence (CTI), which has been associated with autonomic dysfunction, has not been elucidated in patients without heart failure (HF). Methods: Cardiac PET using 11C-CGP12177 was performed to investigate the cardiac β-adrenergic receptor density (β-ARD) in 13 patients with CTI without HF and 6 healthy controls. The maximum number of available specific 11C-CGP12177 binding sites per gram of tissue was calculated in regions of interest using an established graphical method. Results: Peak heart rate was significantly lower in CTI patients than in controls (116.9 ± 11.0 vs. 154.8 ± 14.4 beats/min, P < 0.001). β-ARD of the total myocardium was significantly lower in CTI patients than in controls (4.3 ± 1.7 vs. 7.0 ± 1.7 pmol/mL, P = 0.005). Conclusion: β-adrenergic receptor downregulation was demonstrated in patients with CTI without HF. Decreased β-ARD is a common feature in patients with CTI, with or without HF.
Keywords: PET; chronotropic incompetence; sympathetic nervous system; β-adrenergic receptor.
© 2021 by the Society of Nuclear Medicine and Molecular Imaging.