Document Detail


I-123-mIBG myocardial imaging for assessment of risk for a major cardiac event in heart failure patients: insights from a retrospective European multicenter study.
MedLine Citation:
PMID:  18043919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Single-center experiences have shown that myocardial meta-iodobenzylguanidine (mIBG) uptake has prognostic value in heart failure (HF) patients. To verify these observations using a rigorous clinical trial methodology, a retrospective review and prospective quantitative reanalysis was performed on a series of cardiac (123)I-mIBG scans acquired during a 10-year period at six centers in Europe. METHODS: (123)I-mIBG scans obtained on 290 HF patients [(262 with left ventricular ejection fraction (LVEF) < 50%)] from 1993 to 2002 were reanalyzed using a standardized methodology to determine the heart-to-mediastinum ratio (H/M) on delayed planar images. All image results were verified by three independent reviewers. Major cardiac events [MCEs; cardiac death, cardiac transplant, potentially fatal arrhythmia (including implantable cardioverter-defibrillator discharge)] during 24-month follow-up were confirmed by an adjudication committee. RESULTS: MCEs occurred in 67 patients (26%): mean H/M ratio was 1.51 +/- 0.30 for the MCE group and 1.97 +/- 0.54 for the non-MCE group (p < 0.001). Two-year event-free survival using an optimum H/M ratio threshold of 1.75 was 62% for H/M ratio less than 1.75, 95% for H/M ratio greater than or equal to 1.75 (p < 0.0001). Logistic regression showed H/M ratio and LVEF as the only significant predictors of MCE. Using the lower and upper H/M quartiles of 1.45 and 2.17 as high- and very low-risk thresholds, 2-year event-free survival rates were 52% and 98%, respectively. Among patients with LVEF < or = 35% and H/M > or = 1.75 (n = 73), there were nine MCEs because of progressive HF and only one because of an arrhythmia. CONCLUSION: Application of a clinical trial methodology via the retrospective reanalysis of (123)I-mIBG images confirms the previously reported prognostic value of this method in HF patients, including potential identification of a quantitative threshold for low risk for cardiac mortality and potentially fatal ventricular arrhythmias.
Authors:
Denis Agostini; Hein J Verberne; Wolfgang Burchert; Juhani Knuuti; Pavol Povinec; Gianmario Sambuceti; Mustafa Unlu; Montserrat Estorch; Gopa Banerjee; Arnold F Jacobson
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-11-28
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  35     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-27     Completed Date:  2008-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  535-46     Citation Subset:  IM    
Affiliation:
CHU Cote de Nacre, Caen, France. agostini-de@chu-caen.fr
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use*
Adult
Aged
Aged, 80 and over
Coronary Artery Disease / radionuclide imaging*
Europe
Heart / radionuclide imaging*
Heart Failure / radionuclide imaging*
Humans
Middle Aged
Prognosis
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Retrospective Studies
Risk Assessment / methods*
Risk Factors
Sensitivity and Specificity
Ventricular Dysfunction, Left / radionuclide imaging*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 77679-27-7/3-Iodobenzylguanidine
Comments/Corrections
Comment In:
Eur J Nucl Med Mol Imaging. 2008 Mar;35(3):532-4   [PMID:  18210105 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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