Prediction of sudden death in patients with mild-to-moderate chronic heart failure by using cardiac iodine-123 metaiodobenzylguanidine imaging.
OBJECTIVE
To evaluate the usefulness of cardiac iodine-123 (123I) metaiodobenzylguanidine (MIBG) imaging as a predictor of sudden death in patients with chronic heart failure (CHF).


METHODS
Prospective cohort study in a tertiary referral centre.


METHODS
97 outpatients with CHF with a radionuclide left ventricular ejection fraction <40% (mean (SD) 29% (7.5%)).


METHODS
At study entry, cardiac I-123 MIBG imaging was performed. The cardiac MIBG heart-to-mediastinum ratio (H/M) and washout rate (WR) were obtained from MIBG imaging.


METHODS
Patients were assigned to two groups based upon 27% of WR, which was the mean (2SD) control WR. 48 of 97 patients with CHF had abnormal WR (> or =27%), whereas the remaining 49 patients had normal WR (<27%). All the study patients were then followed up.


RESULTS
During the mean (SD) follow-up period of 65 (29) months, 12 (25%) patients in the abnormal WR group and 2 (4%) patients in the normal WR group died suddenly. Kaplan-Meier analysis revealed that sudden death was more often observed in patients with abnormal WR than those with normal WR (p = 0.001). On Cox regression analysis, MIBG WR, H/M on the delayed image and H/M on the early image were significantly associated with sudden death.


CONCLUSIONS
Cardiac MIBG imaging would be useful for predicting sudden death in patients with CHF.
Kioka
Hidetaka
H
Division of Cardiology, Osaka General Medical Centre, Osaka, Japan. hidetaka-k@umin.ac.jp
Yamada
Takahisa
T
Mine
Takanao
T
Morita
Takashi
T
Tsukamoto
Yasumasa
Y
Tamaki
Shunsuke
S
Masuda
Masaharu
M
Okuda
Keiji
K
Hori
Masatsugu
M
Fukunami
Masatake
M
D019797:3-Iodobenzylguanidine; D000368:Aged; D002908:Chronic Disease; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D018572:Disease-Free Survival; D015716:Electrocardiography, Ambulatory; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine