title: Relationship between quantitative cardiac neuronal imaging with ¹²³I-meta-iodobenzylguanidine and hospitalization in patients with heart failure.
abstract: OBJECTIVE
  Hospitalization in patients with systolic heart failure is associated with morbidity, mortality, and cost. Myocardial sympathetic innervation, imaged by (123)I-meta-iodobenzylguanidine ((123)I-mIBG), has been associated with cardiac events in a recent multicenter study. The present analysis explored the relationship between (123)I-mIBG imaging findings and hospitalization.
  
  
  METHODS
  Source documents from the ADMIRE-HF trial were reviewed to identify hospitalization events in patients with systolic heart failure following cardiac neuronal imaging using (123)I-mIBG. Time to hospitalization was analyzed with the Kaplan-Meier method and compared to the mIBG heart-to-mediastinum (H/M) ratio using multiple-failure Cox regression.
  
  
  RESULTS
  During 1.4 years of median follow-up, 362 end-point hospitalizations occurred in 207 of 961 subjects, 79 % of whom had H/M ratio <1.6. Among subjects hospitalized for any cause, 88 % had H/M ratio <1.6 and subjects with H/M ratio <1.6 experienced hospitalization earlier than subjects with higher H/M ratios (log-rank p = 0.003). After adjusting for elevated brain natriuretic peptide (BNP) and time since heart failure diagnosis, a low mIBG H/M ratio was associated with cardiac-related hospitalization (HR 1.48, 95 % CI 1.05 - 2.0; p = 0.02).
  
  
  CONCLUSIONS
  The mIBG H/M ratio may risk-stratify patients with heart failure for cardiac-related hospitalization, especially when used in conjunction with BNP. Further studies are warranted to examine these relationships.
authors.affiliation: School of Medicine Department of Medicine, University of Connecticut, Farmington, CT, USA, mwp8@georgetown.edu.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Parker
authors.forename: Nitesh
authors.initials: N
authors.lastname: Sood
authors.forename: Alan W
authors.initials: AW
authors.lastname: Ahlberg
authors.forename: Arnold F
authors.initials: AF
authors.lastname: Jacobson
authors.forename: Gary V
authors.initials: GV
authors.lastname: Heller
authors.forename: Justin B
authors.initials: JB
authors.lastname: Lundbye
mesh_terms: D019797:3-Iodobenzylguanidine; D005260:Female; D006321:Heart / Q000294:innervation*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013564:Sympathetic Nervous System / Q000473:pathology*
chemical_list: D019797:3-Iodobenzylguanidine