Document Detail


Prognostic implications of an initial loss of cardiac metaiodobenzylguanidine uptake and diabetes mellitus in patients with left ventricular dysfunction.
MedLine Citation:
PMID:  12751132     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although altered cardiac sympathetic innervation is related to fatal outcome, the mechanisms and prognostic value of an initial cardiac metaiodobenzylguanidine (MIBG) defect are not known. METHODS AND RESULTS: After quantitative cardiac MIBG imaging, 205 patients with left ventricular ejection fraction <50% were prospectively followed up with a primary end-point of cardiac death for 35 months. In regard to 38 cardiac deaths, consisting of 25 pump failure deaths, 11 sudden deaths, and 2 fatal acute myocardial infarctions, multivariate analysis identified diabetes mellitus as a significant independent predictor as well as reduced cardiac MIBG activity, use of nitrate, and New York Heart Association functional status. Independent of washout kinetics and cardiac function, patients with profound loss of initial MIBG uptake and those with late-phase MIBG activity of 1.74 or less had significantly greater mortality rates than did their counterparts. Initial cardiac MIBG activity closely correlated inversely with annual cardiac death rate. CONCLUSIONS: An initial cardiac MIBG defect and presence of diabetes mellitus indicate a low probability of long-term survival. The profound loss of initial MIBG activity is likely to be due to structural deficit of sympathetic neurons themselves, rather than accelerated sympathetic function, suggesting that denervation is one of mechanisms of cardiac sympathetic dysfunction leading to lethal clinical outcomes.
Authors:
Tomoaki Nakata; Takeru Wakabayashi; Michifumi Kyuma; Tohru Takahashi; Akiyoshi Hashimoto; Hitoko Ogata; Kazufumi Tsuchihashi; Kazuaki Shimamoto
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  9     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-05-16     Completed Date:  2003-07-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  113-21     Citation Subset:  IM    
Affiliation:
Second Department of Internal Medicine (Cardiology), Sapporo Medical University School of Medicine, Sapporo, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use*
Diabetes Mellitus / epidemiology*
Female
Follow-Up Studies
Heart / radionuclide imaging*
Humans
Iodine Radioisotopes / diagnostic use*
Male
Middle Aged
Multivariate Analysis
Prognosis
Prospective Studies
Radiopharmaceuticals / diagnostic use
Risk Factors
Time Factors
Ventricular Dysfunction, Left / complications,  epidemiology,  mortality*
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 77679-27-7/3-Iodobenzylguanidine

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


Previous Document:  Prognosis of congestive heart failure in patients with normal versus reduced ejection fractions: res...
Next Document:  Regression of left ventricular hypertrophy after treatment of hypertension: comparison of directed M...