123I-MIBG imaging detects cardiac involvement and predicts cardiac events in Churg-Strauss syndrome.
OBJECTIVE
In Churg-Strauss syndrome (CSS) it is important to detect cardiac involvement, which predicts poor prognosis. This study evaluated whether (123)I-metaiodobenzylguanidine (MIBG) scintigraphy could detect cardiac damage and predict cardiac events in CSS.


METHODS
(123)I-MIBG scintigraphy was performed in 28 patients with CSS, 12 of whom had cardiac involvement. The early and delayed heart to mediastinum ratio (early H/M and delayed H/M) and washout rate were calculated by using (123)I-MIBG scintigraphy and compared with those in control subjects.


RESULTS
Early H/M and delayed H/M were significantly lower and the washout rate was significantly higher in patients with cardiac involvement than in those without and in controls (early H/M, p = 0.0024, p = 0.0001; delayed H/M, p = 0.0002, p = 0.0001; washout rate, p = 0.0012, p = 0.0052 vs those without and vs controls, respectively). Accuracy for detecting cardiac involvement was 86% for delayed H/M and washout rate and 79% for early H/M and B-type natriuretic peptide (BNP). Kaplan-Meier analysis showed significantly lower cardiac event-free rates in patients with early H/M ≤ 2.18 and BNP > 21.8 pg/ml than those with early H/M > 2.18 and BNP ≤ 21.8 pg/ml (log-rank test p = 0.006).


CONCLUSIONS
Cardiac sympathetic nerve function was damaged in CSS patients with cardiac involvement. (123)I-MIBG scintigraphy was useful in detecting cardiac involvement and in predicting cardiac events.
Horiguchi
Yoriko
Y
Department of Cardiology, National Hospital Organization Sagamihara National Hospital, Minami-ku, Sagamihara City, Kanagawa, Japan. DZQ04361@nifty.com
Morita
Yukiko
Y
Tsurikisawa
Naomi
N
Akiyama
Kazuo
K
D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon
D019797:3-Iodobenzylguanidine