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meta-Hydroxyephedrine (HED), also known as N-methyl-metaraminol or 11C-meta-hydroxyephedrine when radiolabeled, is a small molecule catecholamine analog and structural analog of norepinephrine. It is primarily used as a radiotracer in positron emission tomography (PET) imaging to assess sympathetic nervous system function, especially cardiac sympathetic innervation. HED is rapidly transported into sympathetic neurons by the norepinephrine transporter (NET) and stored in vesicles. Its uptake and retention are highly specific to presynaptic sympathetic nerve terminals, making it a quantitative marker for NET density and synaptic norepinephrine levels. HED is resistant to metabolism by monoamine oxidase (MAO) and catechol-O-methyltransferase. It has been investigated for use in heart failure, myocardial ischemia, arrhythmias, sleep apnea syndromes, and localization of endocrine tumors[3][5][6][7][8].
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