Document Detail


Prognostic value of iodine-123-metaiodobenzylguanidine myocardial uptake and heart rate variability in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  16054475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Autonomic nervous system dysfunction is common in congestive heart failure (CHF) and is believed to predispose patients to an increased risk of death. This study aimed to assess the prognostic significance of heart rate variability (HRV) measurements in conjunction with scintigraphic imaging using metaiodobenzylguanidine (MIBG) labeled with iodine-123 (I-123-MIBG), which detects abnormalities in autonomic nervous activity, in patients with stable CHF during optimal medical treatment. The study population included 52 patients (56 +/- 12 years of age) with a mean left ventricular ejection fraction of 31 +/- 12%. All underwent I-123-MIBG scanning and 24-hour ambulatory electrocardiographic monitoring for the analysis of HRV on entrance into the study. The heart/mediastinum MIBG uptake ratio was calculated. HRV analysis included the assessment of time- and frequency-domain variables. During the 2-year follow-up, 14 patients (27%) died. MIBG uptake at 1 hour was less (1.39 +/- 0.10) in nonsurvivors than in survivors (1.50 +/- 0.16; p = 0.013). In univariate Cox regression analysis, MIBG uptake was a significant prognostic factor (p = 0.038, hazard ratio [HR] 0.017, 95% confidence interval [CI] 0.00 to 0.79). Time- and frequency-domain variables were similar in survivors and nonsurvivors. However, high-frequency power was associated with an increased risk for sudden death (HR 0.310, 95% CI 0.101 to 0.954, p = 0.041) but not with all-cause mortality. In conclusion, cardiac I-123-MIBG imaging identifies patients with CHF at high risk of dying and may be a more reliable predictor of overall mortality than HRV.
Authors:
Maria I Anastasiou-Nana; John V Terrovitis; Theodoros Athanasoulis; Lazaros Karaloizos; Anastasios Geramoutsos; Lilika Pappa; Eleftheria P Tsagalou; Stylianos Efentakis; John N Nanas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  96     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-01     Completed Date:  2005-09-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  427-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra Hospital, Athens, Greece. jnanas@ath.forthnet.gr
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / pharmacokinetics*
Cardiomyopathy, Dilated / complications*
Chronic Disease
Female
Heart Failure / etiology,  radionuclide imaging*
Heart Rate / physiology
Humans
Iodine Radioisotopes / pharmacokinetics
Male
Middle Aged
Myocardial Ischemia / complications*
Myocardium / metabolism
Prognosis
Proportional Hazards Models
Radiopharmaceuticals / pharmacokinetics*
Regression Analysis
Statistics, Nonparametric
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


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