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Open Access 04-04-2022 | Heart Failure | Original Article

Simultaneous assessment of myocardial perfusion and adrenergic innervation in patients with heart failure by low-dose dual-isotope CZT SPECT imaging

Authors: Roberta Assante, MD, PhD, Adriana D’Antonio, MD, Teresa Mannarino, MD, Carmela Nappi, MD, PhD, Valeria Gaudieri, MD, PhD, Emilia Zampella, MD, PhD, Pietro Buongiorno, MS, Valeria Cantoni, PhD, Roberta Green, PhD, Nicola Frega, MD, Hein J. Verberne, MD, PhD, Mario Petretta, MD, Alberto Cuocolo, MD, Wanda Acampa, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 6/2022

Abstract

Background

In patients with heart failure (HF) sequential imaging studies have demonstrated a relationship between myocardial perfusion and adrenergic innervation. We evaluated the feasibility of a simultaneous low-dose dual-isotope ¹²³I/^99mTc-acquisition protocol using a cadmium-zinc-telluride (CZT) single-photon emission computed tomography (SPECT) camera.

Methods and results

Thirty-six patients with HF underwent simultaneous low-dose ¹²³I-metaiodobenzylguanidine (MIBG)/^99mTc-sestamibi gated CZT-SPECT cardiac imaging. Perfusion and innervation total defect sizes and perfusion/innervation mismatch size (defined by ¹²³I-MIBG defect size minus ^99mTc-sestamibi defect size) were expressed as percentages of the total left ventricular (LV) surface area. LV ejection fraction (EF) significantly correlated with perfusion defect size (P < .005), innervation defect size (P < .005), and early (P < .05) and late (P < .01) ¹²³I-MIBG heart-to-mediastinum (H/M) ratio. In addition, late H/M ratio was independently associated with reduced LVEF (P < .05). Although there was a significant relationship (P < .001) between perfusion and innervation defect size, innervation defect size was larger than perfusion defect size (P < .001). At multivariable linear regression analysis, ¹²³I-MIBG washout rate (WR) correlated with perfusion/innervation mismatch (P < .05).

Conclusions

In patients with HF, a simultaneous low-dose dual-isotope ¹²³I/^99mTc-acquisition protocol is feasible and could have important clinical implications.

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Title: Simultaneous assessment of myocardial perfusion and adrenergic innervation in patients with heart failure by low-dose dual-isotope CZT SPECT imaging
Authors: Roberta Assante, MD, PhD
Adriana D’Antonio, MD
Teresa Mannarino, MD
Carmela Nappi, MD, PhD
Valeria Gaudieri, MD, PhD
Emilia Zampella, MD, PhD
Pietro Buongiorno, MS
Valeria Cantoni, PhD
Roberta Green, PhD
Nicola Frega, MD
Hein J. Verberne, MD, PhD
Mario Petretta, MD
Alberto Cuocolo, MD
Wanda Acampa, MD, PhD
Publication date: 04-04-2022
Publisher: Springer International Publishing
Keyword: Heart Failure
Published in: Journal of Nuclear Cardiology / Issue 6/2022
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-022-02951-4

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Springer Medicine

Simultaneous assessment of myocardial perfusion and adrenergic innervation in patients with heart failure by low-dose dual-isotope CZT SPECT imaging

Abstract

Background

Methods and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and results

Conclusions

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