Renal Function in Relation to Cardiac (123)I-MIBG Scintigraphy in Patients with Chronic Heart Failure.
The aim of this study was to explore if estimates of renal function could explain variability of (123)I-metaiodobenzylguanidine ((123)I-MIBG) assessed myocardial sympathetic activity. Furthermore estimates of renal function were compared to (123)I-MIBG as predictors of cardiac death in chronic heart failure (CHF). Semi-quantitative parameters of (123)I-MIBG myocardial uptake and washout were calculated using early heart/mediastinum ratio (H/M), late H/M and washout. Renal function was calculated as estimated Creatinine Clearance (e-CC) and as estimated Glomerular Filtration Rate (e-GFR). Thirty-nine patients with CHF (24 males; age: 64.4 ± 10.5 years; NYHA II/III/IV: 17/20/2; LVEF: 24.0 ± 11.5%) were studied. Variability in any of the semi-quantitative (123)I-MIBG myocardial parameters could not be explained by e-CC or e-GFR. During follow-up (60 ± 37 months) there were 6 cardiac deaths. Cox proportional hazard regression analysis showed that late H/M was the only independent predictor for cardiac death (Chi-square 3.2, regression coefficient: -4.095; standard error: 2.063; hazard ratio: 0.17 [95% CI: 0.000-0.950]). Addition of estimates of renal function did not significantly change the Chi-square of the model. Semi-quantitative (123)I-MIBG myocardial parameters are independent of estimates of renal function. In addition, cardiac sympathetic innervation assessed by (123)I-MIBG scintigraphy seems to be superior to renal function in the prediction of cardiac death in CHF patients.
Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC Amsterdam, The Netherlands.
Derk O
DO
Verschure
G Aernout
GA
Somsen
Berthe L F
BL
van Eck-Smit
Hein J
HJ
Verberne