Prediction of sudden cardiac death in patients with chronic heart failure by regional washout rate in cardiac MIBG SPECT imaging
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Abstract
Background
The sympathetic nervous system provides an important trigger for major arrhythmic events through regional heterogeneity of sympathetic activity, which could be evaluated by SPECT imaging as the regional MIBG washout rate (WR). There is little information available on the prognostic value of regional WR in SPECT imaging for the prediction of sudden cardiac death (SCD) in patients with chronic heart failure (CHF).
Methods
We studied 73 CHF outpatients with LVEF < 40%. At study entry, the regional WR was measured in 17 segments on the polar map. We defined abnormal regional WR as both the regional WR range (maximum − minimum regional WR) and maximum regional WR > mean value + 2SD obtained in 15 normal controls.
Results
During a mean follow-up of 7.5 ± 4.1 years, 15 of 73 patients had SCD. The abnormal regional WR and abnormal global WR on planar images were significantly and independently associated with SCD. Patients with both the abnormal regional WR and global WR had a significantly higher risk of SCD than those with none of these criteria.
Conclusions
The analysis of regional MIBG WR on SPECT imaging provides additional prognostic value to global WR on planar images for SCD prediction in CHF patients.
Keywords
MIBG imaging heart failure SPECTAbbreviations
- SPECT
Single-photon emission computed tomography
- MIBG
Meta-iodobenzylguanidine
- WR
Washout rate
- SCD
Sudden cardiac death
- CHF
Chronic heart failure
- LVEF
Left ventricular ejection fraction
- ICD
Implantable cardioverter defibrillator
- HMR
Heart-to-mediastinum ratio
- SES
Summed extent score
- SSS
Summed severity score
Notes
Disclosure
No financial or other relationships that could lead to a conflict of interest are associated with this study.
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