Abstract
Background
To evaluate whether planar 123I-MIBG myocardial scintigraphy predicts risk of death in heart failure (HF) patients up to 5 years after imaging.
Methods and Results
Subjects from ADMIRE-HF were followed for approximately 5 years after imaging (964 subjects, median follow-up 62.7 months). Subjects were stratified according to the heart/mediastinum (H/M) ratio (< 1.60 vs ≥ 1.60) on planar 123I-MIBG scintigraphic images obtained at baseline in ADMIRE-HF. Cox proportional hazards models and Kaplan-Meier analyses were used to evaluate time to death, cardiac death, or arrhythmic events for subjects stratified by H/M ratio, baseline left ventricular ejection fraction (LVEF: < 25% and 25 to ≤ 35%), and by H/M strata within LVEF strata. All-cause mortality was 38.4% vs 20.9% and cardiac mortality was 16.8% vs 4.5%, in subjects with H/M < 1.60 vs ≥ 1.60, respectively (P < 0.05 for both comparisons). Subjects with preserved sympathetic innervation of the myocardium (H/M ≥ 1.60) were at significantly lower risk of all-cause and cardiac death, arrhythmic events, sudden cardiac death, or potentially life-threatening arrhythmias. Within LVEF strata, a trend toward a higher mortality for subjects with H/M < 1.60 was observed reaching significance for LVEF 25 to ≤ 35% only.
Conclusions
During a median follow-up of 62.7 months, patients with H/M ≥ 1.60 were at significantly lower risk of death and arrhythmic events independently of LVEF values.
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Abbreviations
- CHF:
-
Chronic heart failure
- HF:
-
Heart failure
- H/M:
-
Heart/mediastinum
- HR:
-
Hazard ratio
- ICD:
-
Implantable cardioverter defibrillator
- LVAD:
-
Left ventricular assist device
- LVEF:
-
Left ventricular ejection fraction
- MIBG:
-
Metaiodobenzylguanidine
- NYHA:
-
New York Heart Association
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Acknowledgements
Medical writing support was provided by Winfield Consulting.
Disclosures
D Agostini, K Ananthasubramaniam, H Chandna, L Friberg, A Hudnut, M Koren, MI Miyamoto, R Senior, M Shah, MI Travin, J vom Dahl, and WC Levy declare no conflict of interest regarding this study. K Chen was an employee of GE Healthcare.
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Agostini, D., Ananthasubramaniam, K., Chandna, H. et al. Prognostic usefulness of planar 123I-MIBG scintigraphic images of myocardial sympathetic innervation in congestive heart failure: Follow-Up data from ADMIRE-HF. J. Nucl. Cardiol. 28, 1490–1503 (2021). https://doi.org/10.1007/s12350-019-01859-w
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DOI: https://doi.org/10.1007/s12350-019-01859-w