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

Matthew W Parker1, Nitesh Sood, Alan W Ahlberg

  • 1School of Medicine Department of Medicine, University of Connecticut, Farmington, CT, USA, mwp8@georgetown.edu.

European Journal of Nuclear Medicine and Molecular Imaging
|June 12, 2014
PubMed

Insights

A low heart-to-mediastinum (H/M) ratio from iodine-123 meta-iodobenzylguanidine ((123)I-mIBG) imaging is linked to earlier hospitalizations in systolic heart failure patients. This imaging marker may help identify patients at higher risk for cardiac events.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Heart Failure Management

Background:

  • Hospitalization in systolic heart failure (SHF) patients significantly impacts morbidity, mortality, and healthcare costs.
  • Myocardial sympathetic denervation, assessed via (123)I-mIBG imaging, has been previously linked to adverse cardiac events.
  • The heart-to-mediastinum (H/M) ratio from (123)I-mIBG scans quantifies sympathetic innervation.

Purpose of the Study:

  • To investigate the association between (123)I-mIBG imaging findings, specifically the H/M ratio, and hospitalization events in patients with SHF.
  • To determine if myocardial sympathetic innervation patterns can predict future hospitalizations in SHF.

Main Methods:

  • Analysis of data from the ADMIRE-HF trial, focusing on SHF patients who underwent (123)I-mIBG cardiac neuronal imaging.
  • Kaplan-Meier analysis was used to assess time to hospitalization.
  • Multiple-failure Cox regression was employed to evaluate the relationship between the mIBG H/M ratio and hospitalization, adjusting for factors like brain natriuretic peptide (BNP) levels and time since diagnosis.

Main Results:

  • Over a median follow-up of 1.4 years, 362 hospitalizations occurred in 207 out of 961 subjects.
  • A significant majority of hospitalized patients (88%) had a low H/M ratio (<1.6).
  • Subjects with a low H/M ratio (<1.6) experienced hospitalization earlier than those with higher ratios (log-rank p=0.003).
  • After adjusting for BNP and time since diagnosis, a low mIBG H/M ratio was significantly associated with cardiac-related hospitalization (HR 1.48, p=0.02).

Conclusions:

  • The mIBG H/M ratio demonstrates potential as a risk stratification tool for predicting cardiac-related hospitalizations in heart failure patients.
  • Combining (123)I-mIBG imaging with BNP measurements may enhance risk assessment for hospitalization.
  • Further research is recommended to validate and explore these predictive relationships in larger cohorts.
Abstract

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