BACKGROUND: Imaging with (123)I-metaiodobenzylguanidine (MIBG) is used for the assessment of cardiac sympathetic activity (CSA). We analyzed CSA before and after cardiac resynchronization therapy (CRT), and correlated these data with CRT response. METHODS AND RESULTS: Thirty patients with chronic heart failure and classic indications for CRT were prospectively studied before and at least 3 months after CRT. The variables analyzed were: QRS width, left-ventricular ejection fraction (LVEF), left-ventricular end-diastolic diameter (LVEDD), heart/mediastinum MIBG uptake ratio (H/M), and washout rate (WR). After CRT, patients were divided into two groups: group 1 (21 patients), responders improving to functional class (FC) I or II; and group 2 (9 patients), nonresponders remaining in FC III or IV. After CRT, only group 1 showed favorable changes in QRS width (P =.003), LVEF (P =.01), LVEDD (P =.04), and H/M ratio (P =.003). The H/M ratio and WR were associated with CRT response (P =.005 and P =.04, respectively). The H/M ratio was the only independent predictor of CRT response (P =.01). Receiver operating characteristic curves showed that the optimal H/M ratio cutoff point was 1.36 (sensitivity, 75%; specificity, 71%). CONCLUSIONS: Improvement in CSA correlated with a positive CRT response. Lower MIBG uptake before therapy was associated with CRT nonresponse. The H/M ratio could be helpful in selecting patients for CRT.
BACKGROUND: Imaging with (123)I-metaiodobenzylguanidine (MIBG) is used for the assessment of cardiac sympathetic activity (CSA). We analyzed CSA before and after cardiac resynchronization therapy (CRT), and correlated these data with CRT response. METHODS AND RESULTS: Thirty patients with chronic heart failure and classic indications for CRT were prospectively studied before and at least 3 months after CRT. The variables analyzed were: QRS width, left-ventricular ejection fraction (LVEF), left-ventricular end-diastolic diameter (LVEDD), heart/mediastinum MIBG uptake ratio (H/M), and washout rate (WR). After CRT, patients were divided into two groups: group 1 (21 patients), responders improving to functional class (FC) I or II; and group 2 (9 patients), nonresponders remaining in FC III or IV. After CRT, only group 1 showed favorable changes in QRS width (P =.003), LVEF (P =.01), LVEDD (P =.04), and H/M ratio (P =.003). The H/M ratio and WR were associated with CRT response (P =.005 and P =.04, respectively). The H/M ratio was the only independent predictor of CRT response (P =.01). Receiver operating characteristic curves showed that the optimal H/M ratio cutoff point was 1.36 (sensitivity, 75%; specificity, 71%). CONCLUSIONS: Improvement in CSA correlated with a positive CRT response. Lower MIBG uptake before therapy was associated with CRT nonresponse. The H/M ratio could be helpful in selecting patients for CRT.
Authors: William T Abraham; Westby G Fisher; Andrew L Smith; David B Delurgio; Angel R Leon; Evan Loh; Dusan Z Kocovic; Milton Packer; Alfredo L Clavell; David L Hayes; Myrvin Ellestad; Robin J Trupp; Jackie Underwood; Faith Pickering; Cindy Truex; Peggy McAtee; John Messenger Journal: N Engl J Med Date: 2002-06-13 Impact factor: 91.245
Authors: Salvatore Rosanio; Ernst R Schwarz; Masood Ahmad; Praveen Jammula; Antonio Vitarelli; Barry F Uretsky; Yochai Birnbaum; David L Ware; Shaul Atar; Mohammad Saeed Journal: Am J Cardiol Date: 2005-09-01 Impact factor: 2.778
Authors: Robert O Bonow; Susan Bennett; Donald E Casey; Theodore G Ganiats; Mark A Hlatky; Marvin A Konstam; Costas T Lambrew; Sharon-Lise T Normand; Ileana L Piña; Martha J Radford; Andrew L Smith; Lynne Warner Stevenson; Robert O Bonow; Susan J Bennett; Gregory Burke; Kim A Eagle; Harlan M Krumholz; Costas T Lambrew; Jane Linderbaum; Frederick A Masoudi; Sharon-Lise T Normand; James L Ritchie; John S Rumsfeld; John A Spertus Journal: J Am Coll Cardiol Date: 2005-09-20 Impact factor: 24.094
Authors: P Merlet; C Benvenuti; D Moyse; F Pouillart; J L Dubois-Randé; A M Duval; D Loisance; A Castaigne; A Syrota Journal: J Nucl Med Date: 1999-06 Impact factor: 10.057
Authors: H Ogita; T Shimonagata; M Fukunami; K Kumagai; T Yamada; Y Asano; A Hirata; M Asai; H Kusuoka; M Hori; N Hoki Journal: Heart Date: 2001-12 Impact factor: 5.994
Authors: M W Dae; J W O'Connell; E H Botvinick; T Ahearn; E Yee; J P Huberty; H Mori; M C Chin; R S Hattner; J M Herre Journal: Circulation Date: 1989-03 Impact factor: 29.690
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
Authors: John G F Cleland; Jean-Claude Daubert; Erland Erdmann; Nick Freemantle; Daniel Gras; Lukas Kappenberger; Luigi Tavazzi Journal: N Engl J Med Date: 2005-03-07 Impact factor: 91.245
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Authors: Madalena Coutinho Cruz; Ana Abreu; Guilherme Portugal; Helena Santa-Clara; Pedro S Cunha; Mario M Oliveira; Vanessa Santos; Luís Oliveira; Pedro Rio; Inês Rodrigues; Luís A Morais; Rui C Ferreira; Miguel M Carmo Journal: J Nucl Cardiol Date: 2017-12-05 Impact factor: 5.952
Authors: Simone C S Brandão; Silvana A D Nishioka; Maria C P Giorgi; Ji Chen; Rubens Abe; Martino Martinelli Filho; Viviane T Hotta; Marcelo L Vieira; Ernest V Garcia; José C Meneghetti Journal: Eur J Nucl Med Mol Imaging Date: 2009-01-14 Impact factor: 9.236