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Preoperative iodine-123 meta-iodobenzylguanidine imaging is a novel predictor of left ventricular reverse remodeling during treatment with a left ventricular assist device

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  • Artificial Heart (Clinical)
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Abstract

Although left ventricular reverse remodeling (LVRR) is accompanied with an improved clinical course during LV assist device (LVAD) treatment, its preoperative prediction remains uncertain. Twenty-seven heart failure patients with dilated cardiomyopathy were enrolled in this study. Patients underwent 123I-meta-iodobenzylguanidine (MIBG) scintigraphy before LVAD implantation, and were monitored at our institute from 2010 to 2014. This study investigated the prognostic value of preoperative 123I-MIBG parameters for predicting postoperative LVRR. Of the preoperative variables studied, including 123I-MIBG data, washout rate (WR) ≤ 39 % was the only significant, independent predictor of LVRR (defined as LV ejection fraction ≥35 % at 6 months post-LVAD implant using univariate and multivariate logistic regression analyses) (p = 0.036, odds ratio [OR]:14.45). Improved exercise capacity and more frequent opening of the native aortic valve, as well as lower B-type natriuretic peptide plasma levels, were observed in LVRR patients (p < 0.05 for all), although β-blocker doses were comparable with those of non-LVRR patients throughout the 6-month LVAD support period. In conclusion, preoperative 123I-MIBG is a novel predictive tool of LVRR during LVAD support.

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Authors and Affiliations

  1. Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Teruhiko Imamura & Koichiro Kinugawa

  2. Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8655, Japan

    Daisuke Nitta

  3. Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8655, Japan

    Osamu Kinoshita, Kan Nawata & Minoru Ono

Authors
  1. Teruhiko Imamura
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  2. Koichiro Kinugawa
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  3. Daisuke Nitta
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  4. Osamu Kinoshita
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  5. Kan Nawata
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  6. Minoru Ono
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Correspondence to Teruhiko Imamura or Koichiro Kinugawa.

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Imamura, T., Kinugawa, K., Nitta, D. et al. Preoperative iodine-123 meta-iodobenzylguanidine imaging is a novel predictor of left ventricular reverse remodeling during treatment with a left ventricular assist device. J Artif Organs 19, 29–36 (2016). https://doi.org/10.1007/s10047-015-0857-6

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  • DOI: https://doi.org/10.1007/s10047-015-0857-6

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