Τίτλος:
Prognostic value of iodine-123-metaiodobenzylguanidine myocardial uptake
and heart rate variability in chronic congestive heart failure secondary
to ischemic or idiopathic dilated cardiomyopathy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Autonomic nervous system dysfunction is common in congestive heart
failure (CHF) and is believed to predispose patients to an increased
risk of death. This study aimed to assess the prognostic significance of
heart rate variability (HRV) measurements in conjunction with
scintigraphic imaging using metaiodobenzylguanidine (MIBG) labeled with
iodine-123 (I-123-MIBG), which detects abnormalities in autonomic
nervous activity, in patients with stable CHF during optimal medical
treatment. The study population included 52 patients (56 +/- 12 years of
age) with a mean left ventricular ejection fraction of 31 +/- 12%. All
underwent I-123-MIBG scanning and 24-hour ambulatory
electrocardiographic monitoring for the analysis of HRV on entrance into
the study. The heart/mediastinum MIBG uptake ratio was calculated. HRV
analysis included the assessment of time- and frequency-domain
variables. During the 2-year follow-up, 14 patients (27%) died. MIBG
uptake at I hour was less (1.39 +/- 0.10) in nonsurvivors than in
survivors (1.50 +/- 0.16; p = 0.013). In univariate Cox regression
analysis, MIBG uptake was a significant prognostic factor (p = 0.038,
hazard ratio [HR] 0.017, 95% confidence interval [CI] 0.00 to
0.79). Time- and frequency-domain variables were similar in survivors
and nonsurvivors. However, high-frequency power was associated with an
increased risk for sudden death (HR 0.310, 95% CI 0.101 to 0.954, p =
0.041) but not with all-cause mortality. In conclusion, cardiac
I-123-MIBG imaging identifies patients with CHF at high risk of dying
and may be a more reliable predictor of overall mortality than HRV. (c)
2005 Elsevier Inc. All rights reserved.
Συγγραφείς:
Anastasiou-Nana, MI
Terrovitis, JV
Athanasoulis, T and
Karaloizos, L
Geramoutsos, A
Pappa, L
Tsagalou, EP and
Efentakis, S
Nanas, JN
Περιοδικό:
AMERICAN JOURNAL OF CARDIOLOGY
Εκδότης:
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI:
10.1016/j.amjcard.2005.03.093
