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Iodine-123 metaiodobenzylguanidine (MIBG) is used to assess myocardial sympathetic nervous activity, and a decrease in myocardial MIBG uptake and an increase in spillover have been observed in heart failure patients with reduced ejection fraction. Estimated half of patients with heart failure show preserved ejection fraction. Left ventricular hypertrophy is one of the major cause of heart failure patients with preserved ejection fraction (HFpEF). However, kinetics and clinical significance of MIBG remain unclear in patients with HFpEF.
Consecutive 54 patients with HFpEF who are admitted to our hospital due to symptomatic heart failure were included in this study. There were 24 men and 30 women with a mean age of 79 years. MIBG scintigraphy was performed just before discharge under the stable clinical condition. Using anterior planar images, we determined the heart to mediastinum activity ratio (H/M) in the early and the delayed phase. Washout rate (WR) of MIBG from the heart was calculated according to the standard formula. Left ventricular mass (LVM) was also calculated by echocardiographic parameters.
Brain natriuretic polypeptide (BNP) was not correlated with delayed H/M and WR. LVM index was closely correlated with delayed H/M (r=0.467, p=0.007) and WR (r=0.510, p<0.0001). During a mean follow-up of 16 months, a cardiac event including cardiac death or decompensated heart failure requiring hospitalization occurred in 10 patients. The 10 patients showed significantly lower delayed H/M as compared to the other patients without a cardiac event (1.76±0.55 versus 2.41±0.69, p=0.023).
Myocardial sympathetic nervous activity assessed by MIBG is associated with LV hypertrophy and clinical outcome in patients with
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Insights into Diagnosis and Treatment of Heart Failure with Preserved Ejection Fraction
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1220-275
- 2013 American College of Cardiology Foundation