title: Cardiac sympathetic nerve activity can detect congestive heart failure sensitively in patients with hypertrophic cardiomyopathy.
abstract: 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.
authors.affiliation: Department of Cardiology, Kitaishikai Hospital, Tokunomori 2632-3, Ozu, Ehime 795-8505, Japan. ghiasa@cnw.ne.jp
authors.forename: Go
authors.initials: G
authors.lastname: Hiasa
authors.forename: Mareomi
authors.initials: M
authors.lastname: Hamada
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Saeki
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ogimoto
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shigematsu
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine