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Impact of aging on cardiac sympathetic innervation measured by 123I-mIBG imaging in patients with systolic heart failure

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Sympathetic nervous system (SNS) hyperactivity is a salient characteristic of chronic heart failure (HF) and contributes to the progression of the disease. Iodine-123 meta-iodobenzylguanidine (123I-mIBG) imaging has been successfully used to assess cardiac SNS activity in HF patients and to predict prognosis. Importantly, SNS hyperactivity characterizes also physiological ageing, and there is conflicting evidence on cardiac 123I-mIBG uptake in healthy elderly subjects compared to adults. However, little data are available on the impact of ageing on cardiac sympathetic nerve activity assessed by 123I-mIBG scintigraphy, in patients with HF.

Methods and results

We studied 180 HF patients (age = 66.1 ± 10.5 years [yrs]), left ventricular ejection fraction (LVEF = 30.6 ± 6.3 %) undergoing cardiac 123I-mIBG imaging. Early and late heart to mediastinum (H/M) ratios and washout rate were calculated in all patients. Demographic, clinical, and echocardiographic data were also collected. Our study population consisted of 53 patients aged >75 years (age = 77.7 ± 4.0 year), 67 patients aged 62–72 years (age = 67.9 ± 3.2 years) and 60 patients aged ≤61 year (age = 53.9 ± 5.6 years). In elderly patients, both early and late H/M ratios were significantly lower compared to younger patients (p < 0.05). By multivariate analysis, H/M ratios (both early and late) and washout rate were significantly correlated with LVEF and age.

Conclusions

Our data indicate that, in a population of HF patients, there is an independent age-related effect on cardiac SNS innervation assessed by 123I-mIBG imaging. This finding suggests that cardiac 123I-mIBG uptake in patients with HF might be affected by patient age.

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Authors and Affiliations

  1. Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Telese Terme, Italy

    Giuseppe Rengo, Dino Franco Vitale & Nicola Ferrara

  2. Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy

    Giuseppe Rengo, Gennaro Pagano, Roberto Formisano, Klara Komici, Laura Petraglia, Valentina Parisi, Grazia Daniela Femminella, Claudio de Lucia, Alessandro Cannavo, Alessia Memmi, Dario Leosco & Nicola Ferrara

  3. SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy

    Stefania Paolillo & Alberto Cuocolo

  4. Department of Cardiology, Fatebenefratelli Hospital, Naples, Italy

    Emilio Attena

  5. Institute of Biostructures and Bioimages of the National Council of Research, Naples, Italy

    Teresa Pellegrino

  6. Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy

    Teresa Pellegrino & Alberto Cuocolo

  7. Division of Cardiology, Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, Acerra, Naples, Italy

    Santo Dellegrottaglie

  8. Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy

    Bruno Trimarco & Pasquale Perrone Filardi

Authors
  1. Giuseppe Rengo
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  2. Gennaro Pagano
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Corresponding author

Correspondence to Dario Leosco.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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The first two authors equally contributed

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Rengo, G., Pagano, G., Vitale, D.F. et al. Impact of aging on cardiac sympathetic innervation measured by 123I-mIBG imaging in patients with systolic heart failure. Eur J Nucl Med Mol Imaging 43, 2392–2400 (2016). https://doi.org/10.1007/s00259-016-3432-3

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  • DOI: https://doi.org/10.1007/s00259-016-3432-3

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