title: Significance of I-123 metaiodobenzylguanidine (¹²³I-MIBG) lung activity in subjects with heart failure in comparison to healthy control subjects.
abstract: BACKGROUND
  Little is known concerning the significance of lung activity of the sympathetic neuronal imaging agent (123)I-MIBG in heart failure patients and healthy subjects.
  
  
  METHODS
  (123)I-MIBG activity was assessed in lung, heart, and mediastinum regions of interest on early and late planar images in 951 heart failure patients and 94 controls. Cox regression analyses were performed to identify factors associated with outcome events during a median 17 month follow-up.
  
  
  RESULTS
  Heart failure subjects with pulmonary disease had significantly reduced late lung-to-mediastinum (L/M) ratios compared to heart failure subjects without pulmonary disease. Late L/M ratio was greater in heart failure subjects without outcome events than either subjects with events or healthy controls. L/M ratio was an independent predictor of all-cause mortality. Subjects with combined favorable prognosis L/M ratio ≥ 1.7 and heart-to-mediastinum ratio (H/M) ≥ 1.6 had a significantly lower 2-year mortality (2.0%) than subjects with unfavorable L/M ratio < 1.7 and H/M ratio < 1.6 (17.7% 2-year mortality, P < .0008).
  
  
  CONCLUSIONS
  Increased (123)I-MIBG lung activity in heart failure subjects, compared to controls, is associated with a relatively low risk of adverse events, including all-cause mortality. L/M ratio may, therefore, be useful to provide incremental prognostic information on (123)I-MIBG imaging.
authors: Division of Cardiology, Department of Internal Medicine, University of Cincinnati College of Medicine, PO Box 670542, Cincinnati, OH 45267-0542, USA. myron.gerson@uc.edu
authors: Myron C
authors: MC
authors: Gerson
authors: Alok K
authors: AK
authors: Dwivedi
authors: Mouhamad
authors: M
authors: Abdallah
authors: Rakesh
authors: R
authors: Shukla
authors: Arnold F
authors: AF
authors: Jacobson
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012044:Regression Analysis
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
references: J Am Coll Cardiol. 1988 Nov;12(5):1252-8
references: 3170968
references: Eur J Nucl Med Mol Imaging. 2009 Aug;36(8):1322-8
references: 19259662
references: Respirology. 2010 Nov;15(8):1215-9
references: 20920125
references: J Nucl Med. 2003 Nov;44(11):1747-54
references: 14602855
references: J Nucl Med. 1993 Jul;34(7):1140-6
references: 8315492
references: J Nucl Med. 1999 Dec;40(12):2088-93
references: 10616890
references: Eur J Nucl Med. 1988;13(10):543-7
references: 3371377
references: J Nucl Med. 2006 Mar;47(3):437-42
references: 16513613
references: J Nucl Cardiol. 2002 Nov-Dec;9(6):608-15
references: 12466785
references: Circ Res. 1977 Jul;41(1):108-117
references: 193655
references: Am J Cardiol. 2008 May 15;101(10):1482-6
references: 18471462
references: Br J Pharmacol. 1985 Aug;85(4):933-41
references: 2994790
references: Am J Cardiol. 1980 Aug;46(2):189-96
references: 7405832
references: J Am Coll Cardiol. 2010 May 18;55(20):2212-21
references: 20188504