title: Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: a systematic review.
abstract: OBJECTIVE
  To derive a more precise estimate of the prognostic significance of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters [early heart mediastinal ratio (H/M), late H/M, and myocardial washout] in heart failure (HF).
  
  
  RESULTS
  Eighteen studies with a total of 1755 patients, stratifying survival, and cardiac events in patients with HF by MIBG, were eligible for analysis. The pooled hazard ratio (HR) estimates for cardiac death and cardiac events associated with washout showed no significant heterogeneity and were 1.72 [95%CI (confidence interval), 1.72-2.52; P = 0.006] and 1.08 (95%CI: 1.03-1.12; P < 0.001), respectively. The pooled HR estimates for cardiac death and cardiac events associated with early H/M and late H/M showed significant heterogeneity (I2 > or = 75%). Limiting the pooling to the qualitative best three studies rendered I2 insignificant (I2 = 0) and resulted in a pooled HR of late H/M for cardiac death of 1.82 (95%CI: 0.80-4.12; P = 0.15) and for cardiac events of 1.98 (95%CI: 1.57-2.50; P < 0.001).
  
  
  CONCLUSIONS
  Our results indicate that patients with HF and decreased late H/M or increased myocardial MIBG washout have a worse prognosis compared with those with normal semi-quantitative myocardial MIBG parameters.
authors: Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, F2-238, PO Box 22700, 1100 DE Amsterdam, The Netherlands. h.j.verberne@amc.uva.nl
authors: Hein J
authors: HJ
authors: Verberne
authors: Lizzy M
authors: LM
authors: Brewster
authors: G Aernout
authors: GA
authors: Somsen
authors: Berthe L F
authors: BL
authors: van Eck-Smit
mesh_terms: D019797:3-Iodobenzylguanidine / Q000378:metabolism*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000378:metabolism*; D006801:Humans; D008297:Male; D008482:Mediastinum; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine