title: Cardiac I123-MIBG correlates better than ejection fraction with symptoms severity in systolic heart failure.
abstract: BACKGROUND
  The association of autonomic activation, left ventricular ejection fraction (LVEF) and heart failure functional class is poorly understood.
  
  
  OBJECTIVE
  Our aim was to correlate symptom severity with cardiac sympathetic activity, through iodine-123-metaiodobenzylguanidine (123I-MIBG) scintigraphy and with LVEF in systolic heart failure (HF) patients without previous beta-blocker treatment.
  
  
  METHODS
  Thirty-one patients with systolic HF, class I to IV of the New York Heart Association (NYHA), without previous beta-blocker treatment, were enrolled and submitted to 123I-MIBG scintigraphy and to radionuclide ventriculography for LVEF determination. The early and delayed heart/mediastinum (H/M) ratio and the washout rate (WR) were performed.
  
  
  RESULTS
  According with symptom severity, patients were divided into group A, 13 patients in NYHA class I/II, and group B, 18 patients in NYHA class III/IV. Compared with group B patients, group A had a significantly higher LVEF (25% ± 12% in group B vs. 32% ± 7% in group A, p = 0.04). Group B early and delayed H/M ratios were lower than group A ratios (early H/M 1.49 ± 0.15 vs. 1.64 ± 0.14, p = 0.02; delayed H/M 1.39 ± 0.13 vs. 1.58 ± 0.16, p = 0.001, respectively). WR was significantly higher in group B (36% ± 17% vs. 30% ± 12%, p= 0.04). The variable that showed the best correlation with NYHA class was the delayed H/M ratio (r= -0.585; p=0.001), adjusted for age and sex.
  
  
  CONCLUSIONS
  This study showed that cardiac 123I-MIBG correlates better than ejection fraction with symptom severity in systolic heart failure patients without previous beta-blocker treatment.
authors.affiliation: Programa de Pós-Graduação em Ciências Cardiovasculares, Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil.
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Miranda
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Moscavitch
authors.forename: Larissa R
authors.initials: LR
authors.lastname: Carestiato
authors.forename: Renata M
authors.initials: RM
authors.lastname: Felix
authors.forename: Ronaldo C
authors.initials: RC
authors.lastname: Rodrigues
authors.forename: Leandro R
authors.initials: LR
authors.lastname: Messias
authors.forename: Jader C
authors.initials: JC
authors.lastname: Azevedo
authors.forename: Antonio Cláudio L
authors.initials: AC
authors.lastname: Nóbrega
authors.forename: Evandro Tinoco
authors.initials: ET
authors.lastname: Mesquita
authors.forename: Claudio Tinoco
authors.initials: CT
authors.lastname: Mesquita
mesh_terms: D019797:3-Iodobenzylguanidine; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D005260:Female; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology*
chemical_list: D000319:Adrenergic beta-Antagonists; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
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