Erschienen in:
29.08.2019 | Original Article
Prognostic usefulness of planar 123I-MIBG scintigraphic images of myocardial sympathetic innervation in congestive heart failure: Follow-Up data from ADMIRE-HF
verfasst von:
Denis Agostini, MD, PhD, Karthikeyan Ananthasubramaniam, MD, Harish Chandna, MD, Lars Friberg, MD, Andrew Hudnut, MD, Michael Koren, MD, Michael I. Miyamoto, MD, Roxy Senior, MD, Mahesh Shah, MD, Mark I. Travin, MD, Jürgen vom Dahl, MD, Kun Chen, PhD, Wayne C. Levy, MD, on behalf of the ADMIRE-HF investigators
Erschienen in:
Journal of Nuclear Cardiology
|
Ausgabe 4/2021
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Abstract
Background
To evaluate whether planar 123I-MIBG myocardial scintigraphy predicts risk of death in heart failure (HF) patients up to 5 years after imaging.
Methods and Results
Subjects from ADMIRE-HF were followed for approximately 5 years after imaging (964 subjects, median follow-up 62.7 months). Subjects were stratified according to the heart/mediastinum (H/M) ratio (< 1.60 vs ≥ 1.60) on planar 123I-MIBG scintigraphic images obtained at baseline in ADMIRE-HF. Cox proportional hazards models and Kaplan-Meier analyses were used to evaluate time to death, cardiac death, or arrhythmic events for subjects stratified by H/M ratio, baseline left ventricular ejection fraction (LVEF: < 25% and 25 to ≤ 35%), and by H/M strata within LVEF strata. All-cause mortality was 38.4% vs 20.9% and cardiac mortality was 16.8% vs 4.5%, in subjects with H/M < 1.60 vs ≥ 1.60, respectively (P < 0.05 for both comparisons). Subjects with preserved sympathetic innervation of the myocardium (H/M ≥ 1.60) were at significantly lower risk of all-cause and cardiac death, arrhythmic events, sudden cardiac death, or potentially life-threatening arrhythmias. Within LVEF strata, a trend toward a higher mortality for subjects with H/M < 1.60 was observed reaching significance for LVEF 25 to ≤ 35% only.
Conclusions
During a median follow-up of 62.7 months, patients with H/M ≥ 1.60 were at significantly lower risk of death and arrhythmic events independently of LVEF values.