| 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. | |
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MedLine Citation:
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PMID: 18043919 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2007-11-28 |
Journal Detail:
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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:
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Created Date: 2008-03-27 Completed Date: 2008-07-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140988 Medline TA: Eur J Nucl Med Mol Imaging Country: Germany |
Other Details:
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Languages: eng Pagination: 535-46 Citation Subset: IM |
Affiliation:
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CHU Cote de Nacre, Caen, France. agostini-de@chu-caen.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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3-Iodobenzylguanidine
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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:
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0/Radiopharmaceuticals; 77679-27-7/3-Iodobenzylguanidine |
| Comments/Corrections | |
Comment In:
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Eur J Nucl Med Mol Imaging. 2008 Mar;35(3):532-4
[PMID:
18210105
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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