TY - JOUR T1 - Markers of inflammation in relation to myocardial 123I-mIBG scintigraphy in patients with chronic heart failure JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1653 LP - 1653 VL - 57 IS - supplement 2 AU - Derk Verschure AU - Berthe van Eck-Smit AU - G. Somsen AU - Hein Verrberne Y1 - 2016/05/01 UR - http://jnm.snmjournals.org/content/57/supplement_2/1653.abstract N2 - 1653Objectives Chronic heart failure (CHF) results in increased, cardiac sympathetic activity and myocardial inflammation. Production of cytokines and other inflammatory markers may be regulated by the sympathetic nervous system. The aim of this study was to identify the relationship between cardiac sympathetic activity assessed with 123I-mIBG scintigraphy and markers of inflammation (e.g. CRP, IL12p40, sE-selectin, MPO, PAI-1,tPA and TNFRII) in subjects with stable, optimally treated heart failure. In addition, the predictive value of inflammatory markers and 123I-mIBG parameters for cardiac events (ventricular arrhythmia, progression of CHF, cardiac death) were evaluated.Methods Fifty-five CHF patients (age 66.3±8.0 years, 78% male, LVEF 22.4±6.3) referred for cardiac 123I-mIBG planar scintigraphy were enrolled. Median follow-up was 31 months (2 - 58 months). At 15 minutes (early Heart/Mediastinum (H/M)) and 4 hours (late H/M) after i.v. administration of 185 MBq, images were acquired using gamma-camera’s equipped with medium energy collimators. In addition, washout (WO) was calculated. Inflammatory markers were measured in a blood samples, taken just before 123I-mIBG was administered.Results Mean early H/M was 2.12±0.39, late H/M 1.84±0.40 and WO 13.0±10.9. Only LVEF was an independent predictor of late H/M (adjusted R2 = 0.100, p = 0.011). NT-proBNP was an independent predictor of WO (adjusted R2 = 0.090, p = 0.015). CRP, TNFα, sE-selectin, IL12p40, MPO, PAI-1,tPA, TNFR2 were not related to late H/M and WO. During follow-up, 13 patients experienced a cardiac event (ventricular arrhythmia(4), progression of CHF(4) and cardiac death(5)). Univariate Cox regression analysis showed that the risk of a cardiac event was associated with increased CRP (HR 1.047, p < 0.001), NT-proBNP (HR 1.141, p = 0.023) MPO (HR 0.985, p = 0.030) and late H/M (HR 0.182, p = 0.042). Multivariate Cox regression analysis showed that only CRP, NT-proBNP, MPO and IL-12p40 were independent predictors of a cardiac event.Conclusions In this specific CHF population general inflammation and cardiac sympathetic activity are both independent prognostic indicators. ER -