title: Iodine-123-metaiodobenzylguanidine imaging can predict future cardiac events in heart failure patients with preserved ejection fraction.
abstract: OBJECTIVE
  Iodine-123-metaiodobenzylguanidine ((123)I-MIBG) has been used to assess the function of the cardiac sympathetic nervous system in patients with chronic heart failure (HF). The usefulness of (123)I-MIBG imaging for evaluating patients with heart failure with preserved ejection fraction (HFPEF) has not been established.
  
  
  METHODS
  We performed (123)I-MIBG scintigraphy and echocardiography and measured the plasma brain natriuretic peptide (BNP) levels of 117 consecutive HF patients (64 men, mean age 66 ± 14 years) with a left ventricular ejection fraction (LVEF) of ≥50% who were admitted to our hospital. Patients were divided into 2 groups according to the New York Heart Association (NYHA) functional class.
  
  
  RESULTS
  The (123)I-MIBG delayed heart-to-mediastinum (H/M) ratio was significantly lower, and the washout rate (WR) was higher in patients with HFPEF with advanced NYHA functional class (NYHA functional class I and II vs. III: 1.90 ± 0.34 vs. 1.49 ± 0.32, p < 0.0001; 25.9 ± 13.4 vs. 46.9 ± 16.3%, p < 0.0001, respectively). On the other hand, the (123)I-MIBG WR was not correlated with LVEF and had a weak correlation with plasma BNP levels (R = 0.207, p = 0.0346). Moreover, patients with a high (123)I-MIBG WR showed a poor clinical outcome (p = 0.0033).
  
  
  CONCLUSIONS
  (123)I-MIBG imaging provides independent prognostic information in patients with HFPEF.
authors.affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, Japan.
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Katoh
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shishido
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kutsuzawa
authors.forename: Takanori
authors.initials: T
authors.lastname: Arimoto
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Netsu
authors.forename: Akira
authors.initials: A
authors.lastname: Funayama
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ishino
authors.forename: Takeshi
authors.initials: T
authors.lastname: Niizeki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishiyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Takehiko
authors.initials: T
authors.lastname: Miyashita
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Joji
authors.initials: J
authors.lastname: Nitobe
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: D019797:3-Iodobenzylguanidine / Q000493:pharmacokinetics; D000368:Aged; D003952:Diagnostic Imaging; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D012306:Risk; D013318:Stroke Volume
chemical_list: D020097:Natriuretic Peptide, Brain; D019797:3-Iodobenzylguanidine