Document Detail


Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure. Results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study.
MedLine Citation:
PMID:  20188504     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study prospectively evaluated iodine-123 meta-iodobenzylguanidine ((123)I-mIBG) imaging for identifying symptomatic heart failure (HF) patients most likely to experience cardiac events. BACKGROUND: Single-center studies have demonstrated the poorer prognosis of HF patients with reduced (123)I-mIBG myocardial uptake, but these observations have not been validated in large multicenter trials. METHODS: A total of 961 subjects with New York Heart Association (NYHA) functional class II/III HF and left ventricular ejection fraction (LVEF) < or =35% were studied. Subjects underwent (123)I-mIBG myocardial imaging (sympathetic neuronal integrity quantified as the heart/mediastinum uptake ratio [H/M] on 4-h delayed planar images) and myocardial perfusion imaging and were then followed up for up to 2 years. Time to first occurrence of NYHA functional class progression, potentially life-threatening arrhythmic event, or cardiac death was compared with H/M (either in relation to estimated lower limit of normal [1.60] or as a continuous variable) using Cox proportional hazards regression. Multivariable analyses using clinical, laboratory, and imaging data were also performed. RESULTS: A total of 237 subjects (25%) experienced events (median follow-up 17 months). The hazard ratio for H/M > or =1.60 was 0.40 (p < 0.001); the hazard ratio for continuous H/M was 0.22 (p < 0.001). Two-year event rate was 15% for H/M > or =1.60 and 37% for H/M <1.60; hazard ratios for individual event categories were as follows: HF progression, 0.49 (p = 0.002); arrhythmic events, 0.37 (p = 0.02); and cardiac death, 0.14 (p = 0.006). Significant contributors to the multivariable model were H/M, LVEF, B-type natriuretic peptide, and NYHA functional class. (123)I-mIBG imaging also provided additional discrimination in analyses of interactions between B-type natriuretic peptide, LVEF, and H/M. CONCLUSIONS: ADMIRE-HF provides prospective validation of the independent prognostic value of (123)I-mIBG scintigraphy in assessment of patients with HF. (Meta-Iodobenzylguanidine Scintigraphy Imaging in Patients With Heart Failure and Control Subjects Without Cardiovascular Disease, NCT00126425; Meta-Iodobenzylguanidine [123I-mIBG] Scintigraphy Imaging in Patients With Heart Failure and Control Subjects Without Cardiovascular Disease, NCT00126438).
Authors:
Arnold F Jacobson; Roxy Senior; Manuel D Cerqueira; Nathan D Wong; Gregory S Thomas; Victor A Lopez; Denis Agostini; Fred Weiland; Harish Chandna; Jagat Narula;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-02-25
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  55     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-14     Completed Date:  2010-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2212-21     Citation Subset:  AIM; IM    
Affiliation:
GE Healthcare, Princeton, New Jersey, USA.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00126425;  NCT00126438
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use*
Aged
Disease Progression
Female
Heart / radionuclide imaging
Heart Failure / radionuclide imaging*
Humans
Iodine Radioisotopes
Male
Mediastinum / radionuclide imaging
Middle Aged
Natriuretic Peptide, Brain / blood
Prognosis
Proportional Hazards Models
Prospective Studies
Radiopharmaceuticals / diagnostic use*
Research Design
Risk Assessment
Stroke Volume
Tomography, Emission-Computed, Single-Photon / statistics & numerical data
Ventricular Dysfunction, Left / radionuclide imaging*
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 114471-18-0/Natriuretic Peptide, Brain; 77679-27-7/3-Iodobenzylguanidine
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 May 18;55(20):2222-4   [PMID:  20466202 ]

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


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