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Renal function and cardiac adrenergic impairment in patients affected by heart failure

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Although in heart failure (HF) there is a strict correlation between heart and kidney, no data are available on the potential relationship in HF between renal dysfunction (RD) and the impaired sympathetic innervation. Aim of the present study was to assess the relationship between RD and cardiac sympathetic innervation in HF patients with reduced ejection fraction. Two hundred and sixty-three patients with mild-to-severe HF underwent iodine-123 meta-iodobenzylguanidine myocardial scintigraphy to assess sympathetic innervation, evaluating early and late heart-to-mediastinum (H/M) ratios and washout rate. In all patients, glomerular filtration rate (eGFR) by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula was assessed. A direct association was found between EPI-eGFR and late H/M (r = .215; P < .001). Dividing the population into moderate-to-severe eGFR reduction and normal-to-mildly reduced eGFR (cutoff ≤ 60 mL·min−1·1.73 m−2), a statistically significant reduction of late H/M value was found in patients with RD compared to patients with preserved eGFR (P = .030). By multivariable linear regression analysis, eGFR resulted in the prediction of impaired late H/M in patients with RD (P = .005). Patients with RD and HF show more impaired cardiac sympathetic activity than HF patients with preserved renal function, and reduced eGFR is a predictor of reduced late H/M.

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Abbreviations

HF:

Heart failure

RD:

Renal dysfunction

123I-MIBG:

Iodine-123 meta-iodobenzylguanidine

H/M:

Heart-to-mediastinum

eGFR:

Glomerular filtration rate

LVEF:

Left ventricular ejection fraction

MBq:

Megabecquerel

NYHA:

New York Heart Association

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Disclosure

All authors declare no conflicts of interest.

Author information

Author notes

  1. Fabio Marsico and Stefania Paolillo contributed equally to the study and are considered as first authors

Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy

    Fabio Marsico MD, PhD, Stefania Paolillo MD, PhD, Paola Gargiulo MD, PhD, Carmela Nappi MD, PhD, Roberta Assante MD, PhD, Simona Dell’Aversana MD, Immacolata Esposito MD, Francesco Renga MD, Luca Esposito MD, Luca Bardi MD, Alberto Cuocolo MD, PhD & Pasquale Perrone Filardi MD, PhD

  2. Mediterranea Cardiocentro, Naples, Italy

    Stefania Paolillo MD, PhD

  3. Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy

    Valentina Parisi MD, PhD, Giuseppe Rengo MD, PhD & Dario Leosco MD, PhD

  4. Villa dei Fiori, Acerra, Naples, Italy

    Santo Dellegrottaglie MD, PhD

  5. Istituto Diagnostico Varelli, Naples, Italy

    Caterina Marciano MD

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  1. Fabio Marsico MD, PhD
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Corresponding author

Correspondence to Pasquale Perrone Filardi MD, PhD.

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Marsico, F., Paolillo, S., Gargiulo, P. et al. Renal function and cardiac adrenergic impairment in patients affected by heart failure. J. Nucl. Cardiol. 28, 2112–2122 (2021). https://doi.org/10.1007/s12350-019-01975-7

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  • DOI: https://doi.org/10.1007/s12350-019-01975-7

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