Sex differences in ¹²³I-mIBG scintigraphy imaging techniques in patients with heart failure

Area of Science:

• Cardiology
• Nuclear Medicine
• Medical Imaging

Background:

• Heart failure (HF) management requires effective risk stratification tools.
• ¹²³I-mIBG-scintigraphy assesses cardiac sympathetic denervation.
• Differences in arrhythmic event (AE) prediction between sexes in HF are not fully understood.

Purpose of the Study:

• To evaluate sex-based differences in the predictive value of ¹²³I-mIBG-scintigraphy for cardiac arrhythmic events (AE) in heart failure (HF) patients.
• To determine if ¹²³I-mIBG-scintigraphy can serve as a stratifying tool for AE risk in men and women with HF.

Main Methods:

• Retrospective analysis of 306 HF patients prior to implantable-cardioverter-defibrillator (ICD) implantation.
• Acquisition of early and late planar and SPECT cardiac images using ¹²³I-mIBG-scintigraphy.
• Calculation of heart-to-mediastinum ratio (HM) and segmental scores (SS); Cox regression analysis for AE prediction.

Main Results:

• In the overall population, age, early and late SS (ESS, LSS), and ejection fraction (EF) predicted AE; HM did not.
• In females, no significant predictors for AE were identified.
• In males, ESS, LSS, EF, and late HM were significant predictors of AE; males had a lower risk of AE.

Conclusions:

• ¹²³I-mIBG-scintigraphy is a more effective tool for predicting cardiac arrhythmic events (AE) in male heart failure (HF) patients compared to females.
• Sex-specific differences exist in the utility of ¹²³I-mIBG-scintigraphy for AE risk stratification in HF.