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Iodine-123-metaiodobenzylguanidine imaging can predict future cardiac events in heart failure patients with preserved ejection fraction

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Abstract

Objective

Iodine-123-metaiodobenzylguanidine (123I-MIBG) has been used to assess the function of the cardiac sympathetic nervous system in patients with chronic heart failure (HF). The usefulness of 123I-MIBG imaging for evaluating patients with heart failure with preserved ejection fraction (HFPEF) has not been established.

Methods

We performed 123I-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 123I-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 123I-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 123I-MIBG WR showed a poor clinical outcome (p = 0.0033).

Conclusions

123I-MIBG imaging provides independent prognostic information in patients with HFPEF.

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Acknowledgments

This study was supported, in part, by a grant-in-aid for Scientific Research (No. 19790513, 21590923, 21790700, and 21790701) from the Ministry of Education Culture, Sport, Science, and Technology and a grant-in-aid from the global century center of excellence (COE) program of the Japan Society for the Promotion of Science. We would like to thank Mr. Akio Okada for his technical supports.

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Authors and Affiliations

  1. Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan

    Shigehiko Katoh, Tetsuro Shishido, Daisuke Kutsuzawa, Takanori Arimoto, Shunsuke Netsu, Akira Funayama, Mitsunori Ishino, Takeshi Niizeki, Satoshi Nishiyama, Hiroki Takahashi, Takehiko Miyashita, Takuya Miyamoto, Joji Nitobe, Tetsu Watanabe & Isao Kubota

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  1. Shigehiko Katoh
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Correspondence to Tetsuro Shishido.

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Katoh, S., Shishido, T., Kutsuzawa, D. et al. Iodine-123-metaiodobenzylguanidine imaging can predict future cardiac events in heart failure patients with preserved ejection fraction. Ann Nucl Med 24, 679–686 (2010). https://doi.org/10.1007/s12149-010-0409-3

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  • DOI: https://doi.org/10.1007/s12149-010-0409-3

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