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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 7/2020

01-07-2020 | Obesity | Original Article

Impact of body mass index on cardiac adrenergic derangement in heart failure patients: a 123I-mIBG imaging study

Authors: Klara Komici, Leonardo Bencivenga, Stefania Paolillo, Paola Gargiulo, Roberto Formisano, Roberta Assante, Carmela Nappi, Fabio Marsico, Adriana D’Antonio, Giovanni De Simini, Antonio Cittadini, Dino Franco Vitale, Alberto Cuocolo, Pasquale Perrone Filardi, Nicola Ferrara, Giuseppe Rengo

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2020

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Abstract

Purpose

To assess the impact of body mass index (BMI) on cardiac adrenergic derangement, measured by iodine-123 meta-iodobenzylguanidine (123I-mIBG) imaging in heart failure (HF) patients. Overweight and obesity represent relevant health issues, and augmented sympathetic tone has been described in patients with increased BMI. An extensive literature supports that HF-dependent cardiac denervation, measured through mIBG parameters, is an independent predictor of cardiovascular outcomes and mortality. However, the influence of BMI on cardiac mIBG uptake has not been largely investigated.

Methods

We prospectively enrolled patients with systolic HF, collecting demographic, clinical, echocardiographic data, and mIBG imaging parameters. In order to detect the factors associated with mIBG parameters, a model building strategy, based on the Multivariable Fractional Polynomial algorithm, has been employed.

Results

We studied 249 patients with systolic HF, mean age of 66.4 ± 10.6 years, and mean left ventricular ejection fraction (LVEF) of 30.7% ± 6.4, undergoing cardiac 123I-mIBG imaging to assess HF severity and prognosis. Seventy-eight patients (31.3%) presented a BMI ≥ 30 kg/m2 and obese patients showed a significant reduction in early heart to mediastinum (H/M) ratio (1.66 ± 0.19 vs. 1.75 ± 0.26; p = 0.008) and a trend to reduction in washout rate (33.6 ± 18.3 vs. 38.1 ± 20.1; p = 0.092) compared with patients with BMI < 30 kg/m2. Multiple regression analysis revealed that BMI, age, and LVEF were significantly correlated with early and late H/M ratios.

Conclusions

Results of the present study indicate that BMI, together with LVEF and age, is independently correlated with cardiac mIBG uptake in HF patients.
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Metadata
Title
Impact of body mass index on cardiac adrenergic derangement in heart failure patients: a 123I-mIBG imaging study
Authors
Klara Komici
Leonardo Bencivenga
Stefania Paolillo
Paola Gargiulo
Roberto Formisano
Roberta Assante
Carmela Nappi
Fabio Marsico
Adriana D’Antonio
Giovanni De Simini
Antonio Cittadini
Dino Franco Vitale
Alberto Cuocolo
Pasquale Perrone Filardi
Nicola Ferrara
Giuseppe Rengo
Publication date
01-07-2020
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04658-0

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