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Published in: European Journal of Nuclear Medicine and Molecular Imaging 10/2015

01-09-2015 | Original Article

Alterations of left ventricular deformation and cardiac sympathetic derangement in patients with systolic heart failure: a 3D speckle tracking echocardiography and cardiac 123I-MIBG study

Authors: Dario Leosco, Valentina Parisi, Teresa Pellegrino, Gennaro Pagano, Grazia Daniela Femminella, Agnese Bevilacqua, Stefania Paolillo, Roberto Formisano, Gaetana Ferro, Claudio de Lucia, Maria Prastaro, Pasquale Perrone Filardi, Alberto Cuocolo, Giuseppe Rengo, Nicola Ferrara

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2015

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Abstract

Purpose

Myocardial contractile function is under the control of cardiac sympathetic activity. Three-dimensional speckle tracking echocardiography (3D-STE) and cardiac imaging with 123I-metaiodobenzylguanidine (123I-MIBG) are two sophisticated techniques for the assessment of left ventricular (LV) deformation and sympathetic innervation, respectively, which offer important prognostic information in patients with heart failure (HF). The purpose of this investigation was to explore, in patients with systolic HF, the relationship between LV deformation assessed by 3D-STE and cardiac sympathetic derangement evaluated by 123I-MIBG imaging.

Methods

We prospectively studied 75 patients with systolic HF. All patients underwent a 3D-STE study (longitudinal, circumferential, area and radial) and 123I-MIBG planar and SPECT cardiac imaging.

Results

3D-STE longitudinal, circumferential and area strain values were correlated with 123I-MIBG late heart to mediastinum (H/M) ratio and late SPECT total defect score. After stratification of the patients according to ischaemic or nonischaemic HF aetiology, we observed a good correlation of all 3D-STE measurements with late H/M ratio and SPECT data in the ischaemic group, but in patients with HF of nonischaemic aetiology, no correlation was found between LV deformation and cardiac sympathetic activity. At the regional level, the strongest correlation between LV deformation and adrenergic innervation was found for the left anterior descending coronary artery distribution territory for all four 3D-STE values. In multivariate linear regression analyses, including age, gender, LV ejection fraction, NYHA class, body mass index, heart rate and HF aetiology, only 3D-STE area and radial strain values significantly predicted cardiac sympathetic derangement on 123I-MIBG late SPECT.

Conclusion

This study indicated that 3D-STE measurements are correlated with 123I-MIBG planar and SPECT data. Furthermore, 3D-STE area and radial strain values, but not LVEF, predict cardiac sympathetic derangement in human postischaemic HF.
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Metadata
Title
Alterations of left ventricular deformation and cardiac sympathetic derangement in patients with systolic heart failure: a 3D speckle tracking echocardiography and cardiac 123I-MIBG study
Authors
Dario Leosco
Valentina Parisi
Teresa Pellegrino
Gennaro Pagano
Grazia Daniela Femminella
Agnese Bevilacqua
Stefania Paolillo
Roberto Formisano
Gaetana Ferro
Claudio de Lucia
Maria Prastaro
Pasquale Perrone Filardi
Alberto Cuocolo
Giuseppe Rengo
Nicola Ferrara
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-015-3054-1

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