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

  • Giuseppe Rengo
  • Gennaro Pagano
  • Dino Franco Vitale
  • Roberto Formisano
  • Klara Komici
  • Laura Petraglia
  • Valentina Parisi
  • Grazia Daniela Femminella
  • Claudio de Lucia
  • Stefania Paolillo
  • Alessandro Cannavo
  • Emilio Attena
  • Teresa Pellegrino
  • Santo Dellegrottaglie
  • Alessia Memmi
  • Bruno Trimarco
  • Alberto Cuocolo
  • Pasquale Perrone Filardi
  • Dario LeoscoEmail author
  • Nicola Ferrara
Original Article

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.

Keywords

Age Heart failure 123I-mIBG imaging Norepinephrine Sympathetic nervous system 

Notes

Compliance with ethical standards

Funding

No funding to report.

Conflict of interest

All authors declare no conflict of interest.

Ethical approval

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.

Informed consent

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

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Giuseppe Rengo
    • 1
    • 2
  • Gennaro Pagano
    • 2
  • Dino Franco Vitale
    • 1
  • Roberto Formisano
    • 2
  • Klara Komici
    • 2
  • Laura Petraglia
    • 2
  • Valentina Parisi
    • 2
  • Grazia Daniela Femminella
    • 2
  • Claudio de Lucia
    • 2
  • Stefania Paolillo
    • 3
  • Alessandro Cannavo
    • 2
  • Emilio Attena
    • 4
  • Teresa Pellegrino
    • 5
    • 6
  • Santo Dellegrottaglie
    • 7
  • Alessia Memmi
    • 2
  • Bruno Trimarco
    • 8
  • Alberto Cuocolo
    • 3
    • 6
  • Pasquale Perrone Filardi
    • 8
  • Dario Leosco
    • 2
    Email author
  • Nicola Ferrara
    • 1
    • 2
  1. 1.Salvatore Maugeri Foundation, IRCCSScientific Institute of Telese Terme (BN)Telese TermeItaly
  2. 2.Division of Geriatrics, Department of Translational Medical SciencesUniversity of Naples Federico IINaplesItaly
  3. 3.SDN FoundationInstitute of Diagnostic and Nuclear DevelopmentNaplesItaly
  4. 4.Department of CardiologyFatebenefratelli HospitalNaplesItaly
  5. 5.Institute of Biostructures and Bioimages of the National Council of ResearchNaplesItaly
  6. 6.Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical SciencesFederico II University of NaplesNaplesItaly
  7. 7.Division of CardiologyOspedale Medico-Chirurgico Accreditato Villa dei FioriNaplesItaly
  8. 8.Division of Cardiology, Department of Advanced Biomedical SciencesFederico II University of NaplesNaplesItaly

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