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123I-MIBG imaging detects cardiac involvement and predicts cardiac events in Churg-Strauss syndrome

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

In Churg-Strauss syndrome (CSS) it is important to detect cardiac involvement, which predicts poor prognosis. This study evaluated whether 123I-metaiodobenzylguanidine (MIBG) scintigraphy could detect cardiac damage and predict cardiac events in CSS.

Methods

123I-MIBG scintigraphy was performed in 28 patients with CSS, 12 of whom had cardiac involvement. The early and delayed heart to mediastinum ratio (early H/M and delayed H/M) and washout rate were calculated by using 123I-MIBG scintigraphy and compared with those in control subjects.

Results

Early H/M and delayed H/M were significantly lower and the washout rate was significantly higher in patients with cardiac involvement than in those without and in controls (early H/M, p = 0.0024, p = 0.0001; delayed H/M, p = 0.0002, p = 0.0001; washout rate, p = 0.0012, p = 0.0052 vs those without and vs controls, respectively). Accuracy for detecting cardiac involvement was 86% for delayed H/M and washout rate and 79% for early H/M and B-type natriuretic peptide (BNP). Kaplan-Meier analysis showed significantly lower cardiac event-free rates in patients with early H/M ≤ 2.18 and BNP > 21.8 pg/ml than those with early H/M > 2.18 and BNP ≤ 21.8 pg/ml (log-rank test p = 0.006).

Conclusion

Cardiac sympathetic nerve function was damaged in CSS patients with cardiac involvement. 123I-MIBG scintigraphy was useful in detecting cardiac involvement and in predicting cardiac events.

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Authors and Affiliations

  1. Department of Cardiology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa, 252-0392, Japan

    Yoriko Horiguchi & Yukiko Morita

  2. Clinical Research Centre for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara City, Kanagawa, 252-0392, Japan

    Naomi Tsurikisawa & Kazuo Akiyama

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  1. Yoriko Horiguchi
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  2. Yukiko Morita
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Correspondence to Yoriko Horiguchi.

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Horiguchi, Y., Morita, Y., Tsurikisawa, N. et al. 123I-MIBG imaging detects cardiac involvement and predicts cardiac events in Churg-Strauss syndrome. Eur J Nucl Med Mol Imaging 38, 221–229 (2011). https://doi.org/10.1007/s00259-010-1617-8

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  • DOI: https://doi.org/10.1007/s00259-010-1617-8

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