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Relationship between quantitative cardiac neuronal imaging with 123I-meta-iodobenzylguanidine and hospitalization in patients with heart failure

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

Abstract

Purpose

Hospitalization in patients with systolic heart failure is associated with morbidity, mortality, and cost. Myocardial sympathetic innervation, imaged by 123I-meta-iodobenzylguanidine (123I-mIBG), has been associated with cardiac events in a recent multicenter study. The present analysis explored the relationship between 123I-mIBG imaging findings and hospitalization.

Methods

Source documents from the ADMIRE-HF trial were reviewed to identify hospitalization events in patients with systolic heart failure following cardiac neuronal imaging using 123I-mIBG. Time to hospitalization was analyzed with the Kaplan-Meier method and compared to the mIBG heart-to-mediastinum (H/M) ratio using multiple-failure Cox regression.

Results

During 1.4 years of median follow-up, 362 end-point hospitalizations occurred in 207 of 961 subjects, 79 % of whom had H/M ratio <1.6. Among subjects hospitalized for any cause, 88 % had H/M ratio <1.6 and subjects with H/M ratio <1.6 experienced hospitalization earlier than subjects with higher H/M ratios (log-rank p = 0.003). After adjusting for elevated brain natriuretic peptide (BNP) and time since heart failure diagnosis, a low mIBG H/M ratio was associated with cardiac-related hospitalization (HR 1.48, 95 % CI 1.05 – 2.0; p = 0.02).

Conclusion

The mIBG H/M ratio may risk-stratify patients with heart failure for cardiac-related hospitalization, especially when used in conjunction with BNP. Further studies are warranted to examine these relationships.

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Acknowledgments

The authors acknowledge Harry Lessig, MD, for assisting with the review of clinical source documents.

Disclosures

Dr. Jacobson is an employee of GE Healthcare, the study sponsor. Drs. Heller and Lundbye received grant support from GE Healthcare for this project.

Author information

Authors and Affiliations

  1. School of Medicine Department of Medicine, University of Connecticut, Farmington, CT, USA

    Matthew W. Parker, Nitesh Sood & Justin B. Lundbye

  2. Division of Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA

    Matthew W. Parker, Nitesh Sood & Alan W. Ahlberg

  3. GE Healthcare, Princeton, NJ, USA

    Arnold F. Jacobson

  4. The Intersocietal Accreditation Commission, Ellicott City, MD, USA

    Gary V. Heller

  5. Division of Cardiology, The Hospital of Central Connecticut, New Britain, CT, USA

    Justin B. Lundbye

Authors
  1. Matthew W. Parker
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  2. Nitesh Sood
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  3. Alan W. Ahlberg
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  4. Arnold F. Jacobson
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  5. Gary V. Heller
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  6. Justin B. Lundbye
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Corresponding author

Correspondence to Matthew W. Parker.

Additional information

Supported by an investigator-initiated research grant from GE Healthcare.

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Parker, M.W., Sood, N., Ahlberg, A.W. et al. Relationship between quantitative cardiac neuronal imaging with 123I-meta-iodobenzylguanidine and hospitalization in patients with heart failure. Eur J Nucl Med Mol Imaging 41, 1666–1672 (2014). https://doi.org/10.1007/s00259-014-2819-2

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  • DOI: https://doi.org/10.1007/s00259-014-2819-2

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