Cardiac sympathetic nerve activity can detect congestive heart failure sensitively in patients with hypertrophic cardiomyopathy.
OBJECTIVE
Cardiac sympathetic nerve dysfunction is related to poor clinical outcome in patients with several different heart diseases. However, it is not clear whether cardiac sympathetic nerve activity is useful for predicting the onset of congestive heart failure (CHF) in patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to examine the prognostic value of performing (123)I-labeled metaiodobenzylguanidine (MIBG) scintigraphy in patients with HCM in comparison with other conventional prognostic variables.


METHODS
(123)I-labeled MIBG images were obtained from 84 HCM patients without prior CHF. After measurement of cardiac function, the patients were followed up for 9 to 86 months in our hospital.


RESULTS
According to the cutoff values for the heart/mediastinum ratio (H/M) on delayed images of control subjects (ie, mean - 1 and 2 SDs), the patients were subdivided into the following three groups: group A (H/M, > 2.11; 34 patients); group B (H/M, < 1.86 to </= 2.11; 30 patients); and group C (H/M, </= 1.86; 20 patients). The prevalence of CHF was 0% in group A, 3.3% in group B, and 55.0% in group C. Kaplan-Meier analysis showed a significant difference in the prevalence of CHF among the three groups. Multivariate analysis using the Wald chi(2) test revealed that the delayed H/M was the most powerful predictor of CHF among the variables.


CONCLUSIONS
Cardiac sympathetic nerve activity is useful for predicting the onset of CHF in patients with HCM.
Hiasa
Go
G
Department of Cardiology, Kitaishikai Hospital, Tokunomori 2632-3, Ozu, Ehime 795-8505, Japan. ghiasa@cnw.ne.jp
Hamada
Mareomi
M
Saeki
Hideyuki
H
Ogimoto
Akiyoshi
A
Ohtsuka
Tomoaki
T
Hara
Yuji
Y
Shigematsu
Yuji
Y
D019797:3-Iodobenzylguanidine; D000368:Aged; D002306:Cardiac Volume / Q000502:physiology; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D006321:Heart / Q000294:innervation*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine