Excerpt

Cardiac ¹²³I-mIBG scintigraphy, a non-invasive imaging technique to assess cardiac sympathetic activity, has been shown to be of clinical value, especially for the assessment of prognosis in patients with chronic heart failure (CHF).1,2 The semi-quantification of the images is essential to differentiate normal and abnormal cardiac sympathetic activity and thereby identify respectively the low and high risk groups. In the ADMIRE-HF study (n = 961), so far the largest prospective multicenter study addressing the prognostic value of cardiac ¹²³I-mIBG scintigraphy, a predefined LEHR (low energy high resolution) collimator-derived late heart-to-mediastinum (H/M) ratio < 1.6 was shown to be an independent predictor of heart failure progression, cardiac death, and arrhythmia.1 A pooled individual patient data meta-analysis showed that, in CHF patients (n = 636), the late H/M ratio is not only useful as a dichotomous predictor of events (high vs low risk) but also has prognostic implication over the full range of the outcome value for all event categories except arrhythmias.2 …