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Open Access 01-08-2019 | Original Article

Role of cardiac ¹²³I-mIBG imaging in predicting arrhythmic events in stable chronic heart failure patients with an ICD

Authors: Giuseppe De Vincentis, MD, Viviana Frantellizzi, MD, Francesco Fedele, MD, Alessio Farcomeni, MD, PhD, Paola Scarparo, MD, Nicolò Salvi, MD, Danilo Alunni Fegatelli, MD, PhD, Massimo Mancone, MD, Derk O. Verschure, MD, PhD, Hein J. Verberne, MD, PhD

Published in: Journal of Nuclear Cardiology | Issue 4/2019

Abstract

Background

Despite therapeutic improvement, the prognosis of chronic heart failure (CHF) remains unfavorable partly due to arrhythmia and sudden cardiac death (SCD). This prospective study evaluated myocardial ¹²³I-meta-iodobenzylguanidine (¹²³I-mIBG) scintigraphy as a predictor of arrhythmic events (AE) in CHF patients.

Methods

170 CHF patients referred for implantable cardioverter-defibrillator (ICD) implantation for both primary and secondary prevention were enrolled. All patients underwent planar and SPECT imaging. Early and late heart-to-mediastinum (H/M) ratio, ¹²³I-mIBG washout (WO), early and late summed SPECT scores were calculated The primary endpoint was an AE: sustained ventricular tachycardia, resuscitated cardiac arrest, appropriate ICD therapy or SCD. The secondary endpoint was appropriate ICD therapy.

Results

During a median follow-up of 23.3 months, 69 patients experienced an AE. Early summed score (ESS) was the only independent predictor of AE [HR 1.023 (1.003-1.043)]. Focussing on only patients with an ICD for primary prevention, ESS was the only independent predictor of AE [HR 1.028 (1.007-1.050)]. ¹²³I-mIBG-derived parameters failed to be independent predictors of appropriate ICD therapy. However there was a “bell-shaped” relation between ¹²³I-mIBG scintigraphy-derived parameters and AE and appropriate ICD therapy, i.e., those with intermediate ¹²³I-mIBG abnormalities tended to be at higher risk of events.

Conclusion

Although SPECT ¹²³I-mIBG scintigraphy was associated with AE in CHF patients with ICD implantation for primary and secondary prevention, no association was found between ¹²³I-mIBG scintigraphy-derived parameters and appropriate ICD therapy.

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Title: Role of cardiac 123I-mIBG imaging in predicting arrhythmic events in stable chronic heart failure patients with an ICD
Authors: Giuseppe De Vincentis, MD
Viviana Frantellizzi, MD
Francesco Fedele, MD
Alessio Farcomeni, MD, PhD
Paola Scarparo, MD
Nicolò Salvi, MD
Danilo Alunni Fegatelli, MD, PhD
Massimo Mancone, MD
Derk O. Verschure, MD, PhD
Hein J. Verberne, MD, PhD
Publication date: 01-08-2019
Publisher: Springer International Publishing
Published in: Journal of Nuclear Cardiology / Issue 4/2019
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-018-1258-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Role of cardiac ¹²³I-mIBG imaging in predicting arrhythmic events in stable chronic heart failure patients with an ICD

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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