Prediction of sudden cardiac death in patients with chronic heart failure by regional washout rate in cardiac MIBG SPECT imaging.
3-Iodobenzylguanidine
/ chemistry
Aged
Chronic Disease
Death, Sudden, Cardiac
Echocardiography
Female
Follow-Up Studies
Heart Failure
/ diagnostic imaging
Humans
Male
Middle Aged
Norepinephrine
/ blood
Prognosis
Prospective Studies
Sympathetic Nervous System
/ diagnostic imaging
Tomography, Emission-Computed, Single-Photon
Ventricular Dysfunction, Left
/ physiopathology
MIBG imaging
SPECT
heart failure
Journal
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
09
07
2016
accepted:
13
04
2017
pubmed:
14
5
2017
medline:
10
9
2020
entrez:
14
5
2017
Statut:
ppublish
Résumé
The sympathetic nervous system provides an important trigger for major arrhythmic events through regional heterogeneity of sympathetic activity, which could be evaluated by SPECT imaging as the regional MIBG washout rate (WR). There is little information available on the prognostic value of regional WR in SPECT imaging for the prediction of sudden cardiac death (SCD) in patients with chronic heart failure (CHF). We studied 73 CHF outpatients with LVEF < 40%. At study entry, the regional WR was measured in 17 segments on the polar map. We defined abnormal regional WR as both the regional WR range (maximum - minimum regional WR) and maximum regional WR > mean value + 2SD obtained in 15 normal controls. During a mean follow-up of 7.5 ± 4.1 years, 15 of 73 patients had SCD. The abnormal regional WR and abnormal global WR on planar images were significantly and independently associated with SCD. Patients with both the abnormal regional WR and global WR had a significantly higher risk of SCD than those with none of these criteria. The analysis of regional MIBG WR on SPECT imaging provides additional prognostic value to global WR on planar images for SCD prediction in CHF patients.
Sections du résumé
BACKGROUND
BACKGROUND
The sympathetic nervous system provides an important trigger for major arrhythmic events through regional heterogeneity of sympathetic activity, which could be evaluated by SPECT imaging as the regional MIBG washout rate (WR). There is little information available on the prognostic value of regional WR in SPECT imaging for the prediction of sudden cardiac death (SCD) in patients with chronic heart failure (CHF).
METHODS
METHODS
We studied 73 CHF outpatients with LVEF < 40%. At study entry, the regional WR was measured in 17 segments on the polar map. We defined abnormal regional WR as both the regional WR range (maximum - minimum regional WR) and maximum regional WR > mean value + 2SD obtained in 15 normal controls.
RESULTS
RESULTS
During a mean follow-up of 7.5 ± 4.1 years, 15 of 73 patients had SCD. The abnormal regional WR and abnormal global WR on planar images were significantly and independently associated with SCD. Patients with both the abnormal regional WR and global WR had a significantly higher risk of SCD than those with none of these criteria.
CONCLUSIONS
CONCLUSIONS
The analysis of regional MIBG WR on SPECT imaging provides additional prognostic value to global WR on planar images for SCD prediction in CHF patients.
Identifiants
pubmed: 28500540
doi: 10.1007/s12350-017-0913-0
pii: 10.1007/s12350-017-0913-0
doi:
Substances chimiques
3-Iodobenzylguanidine
35MRW7B4AD
Norepinephrine
X4W3ENH1CV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
109-117Commentaires et corrections
Type : CommentIn
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