| 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. | |
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MedLine Citation:
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PMID: 20188504 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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). |
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Authors:
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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:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-02-25 |
Journal Detail:
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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:
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Created Date: 2010-05-14 Completed Date: 2010-06-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2212-21 Citation Subset: AIM; IM |
Affiliation:
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GE Healthcare, Princeton, New Jersey, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00126425; NCT00126438 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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3-Iodobenzylguanidine
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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:
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0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 114471-18-0/Natriuretic Peptide, Brain; 77679-27-7/3-Iodobenzylguanidine |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 May 18;55(20):2222-4
[PMID:
20466202
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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