What will be the role of I-123 MIBG in improving the outcome of medically treated heart failure patients?

Excerpt

Heart failure (HF) remains the most common cause for hospital admissions in the Medicare age population.1 In recent decades, major advances in medical treatment of HF patients have resulted in longer survival and improved quality of life. Randomized clinical trials have documented that beta-adrenergic blockers (β-blockers), angiotensin-converting enzyme inhibitors (ACE-inhibitors), angiotensin receptor blockers (ARBs), and aldosterone inhibitors have provided improved outcomes for HF patients. Although widely used, these medications have frequently not been used in the doses validated in large clinical trials. This likely reflects concerns about using the full doses of β-blockers in patients with baseline bradycardia and/or using increasing doses of β-blockers, ACE-inhibitors, or ARBs in patients with low baseline systolic blood pressure. Maximum benefit of pharmacologic therapy is limited by inadequate data for drug selection for individual HF patients and inadequate data documenting the optimal therapeutic target for blood pressure and heart rate. …