OBJECTIVE: Iodine-123-metaiodobenzylguanidine ((123)I-MIBG) has been used to assess the function of the cardiac sympathetic nervous system in patients with chronic heart failure (HF). The usefulness of (123)I-MIBG imaging for evaluating patients with heart failure with preserved ejection fraction (HFPEF) has not been established. METHODS: We performed (123)I-MIBG scintigraphy and echocardiography and measured the plasma brain natriuretic peptide (BNP) levels of 117 consecutive HF patients (64 men, mean age 66 ± 14 years) with a left ventricular ejection fraction (LVEF) of ≥50% who were admitted to our hospital. Patients were divided into 2 groups according to the New York Heart Association (NYHA) functional class. RESULTS: The (123)I-MIBG delayed heart-to-mediastinum (H/M) ratio was significantly lower, and the washout rate (WR) was higher in patients with HFPEF with advanced NYHA functional class (NYHA functional class I and II vs. III: 1.90 ± 0.34 vs. 1.49 ± 0.32, p < 0.0001; 25.9 ± 13.4 vs. 46.9 ± 16.3%, p < 0.0001, respectively). On the other hand, the (123)I-MIBG WR was not correlated with LVEF and had a weak correlation with plasma BNP levels (R = 0.207, p = 0.0346). Moreover, patients with a high (123)I-MIBG WR showed a poor clinical outcome (p = 0.0033). CONCLUSIONS: (123)I-MIBG imaging provides independent prognostic information in patients with HFPEF.
OBJECTIVE:Iodine-123-metaiodobenzylguanidine ((123)I-MIBG) has been used to assess the function of the cardiac sympathetic nervous system in patients with chronic heart failure (HF). The usefulness of (123)I-MIBG imaging for evaluating patients with heart failure with preserved ejection fraction (HFPEF) has not been established. METHODS: We performed (123)I-MIBG scintigraphy and echocardiography and measured the plasma brain natriuretic peptide (BNP) levels of 117 consecutive HF patients (64 men, mean age 66 ± 14 years) with a left ventricular ejection fraction (LVEF) of ≥50% who were admitted to our hospital. Patients were divided into 2 groups according to the New York Heart Association (NYHA) functional class. RESULTS: The (123)I-MIBG delayed heart-to-mediastinum (H/M) ratio was significantly lower, and the washout rate (WR) was higher in patients with HFPEF with advanced NYHA functional class (NYHA functional class I and II vs. III: 1.90 ± 0.34 vs. 1.49 ± 0.32, p < 0.0001; 25.9 ± 13.4 vs. 46.9 ± 16.3%, p < 0.0001, respectively). On the other hand, the (123)I-MIBG WR was not correlated with LVEF and had a weak correlation with plasma BNP levels (R = 0.207, p = 0.0346). Moreover, patients with a high (123)I-MIBG WR showed a poor clinical outcome (p = 0.0033). CONCLUSIONS: (123)I-MIBG imaging provides independent prognostic information in patients with HFPEF.
Authors: Satyam Sarma; Douglas Stoller; Joseph Hendrix; Erin Howden; Justin Lawley; Sheryl Livingston; Beverley Adams-Huet; Courtney Holmes; David S Goldstein; Benjamin D Levine Journal: Circ Heart Fail Date: 2020-03-13 Impact factor: 8.790
Authors: Kanokwan Bunsawat; Stephen M Ratchford; Jeremy K Alpenglow; John J Ryan; Russell S Richardson; D Walter Wray Journal: J Card Fail Date: 2020-11-06 Impact factor: 5.712