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Prediction of sudden cardiac death in patients with chronic heart failure by regional washout rate in cardiac MIBG SPECT imaging

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

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.

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Abbreviations

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

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Disclosure

No financial or other relationships that could lead to a conflict of interest are associated with this study.

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Authors and Affiliations

  1. Division of Cardiology, Osaka General Medical Center, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan

    Hironori Yamamoto MD, Takahisa Yamada MD, Shunsuke Tamaki MD, Takashi Morita MD, Yoshio Furukawa MD, Yusuke Iwasaki MD, Masato Kawasaki MD, Atsushi Kikuchi MD, Takumi Kondo MD, Tatsuhisa Ozaki MD, Masahiro Seo MD, Yoshihiro Sato MD, Iyo Ikeda MD, Eiji Fukuhara MD, Makoto Abe MD, Jun Nakamura MD & Masatake Fukunami MD

Authors
  1. Hironori Yamamoto MD
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  2. Takahisa Yamada MD
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  3. Shunsuke Tamaki MD
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  4. Takashi Morita MD
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  9. Takumi Kondo MD
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  11. Masahiro Seo MD
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  14. Eiji Fukuhara MD
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  15. Makoto Abe MD
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  16. Jun Nakamura MD
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  17. Masatake Fukunami MD
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Corresponding author

Correspondence to Takahisa Yamada MD.

Additional information

All editorial decisions for this article, including selection of reviewers and the final decision, were made by guest editor Daniel Berman, MD.

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Yamamoto, H., Yamada, T., Tamaki, S. et al. Prediction of sudden cardiac death in patients with chronic heart failure by regional washout rate in cardiac MIBG SPECT imaging. J. Nucl. Cardiol. 26, 109–117 (2019). https://doi.org/10.1007/s12350-017-0913-0

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  • DOI: https://doi.org/10.1007/s12350-017-0913-0

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