title: Heterogeneity of Ventricular Sympathetic Nervous Activity is Associated with Clinically Relevant Ventricular Arrhythmia in Postoperative Patients with Tetralogy of Fallot.
abstract: This study aimed to clarify whether there is an association between ventricular sympathetic nervous activity (SNA) and clinically relevant ventricular arrhythmia (a run of ≥ 3 consecutive ventricular beats, RVA) in postoperative patients with tetralogy of Fallot (TOF). We performed a retrospective study in a national referral center of pediatric cardiology in Japan. Twenty-four postoperative TOF patients (13 males, median age 17 years) undergoing myocardial (123)I metaiodobenzylguanidine (MIBG) scintigraphy were included. We measured the heart-to-mediastinum ratio (HMR) and washout ratio (WR) from planar MIBG myocardial scintigraphy. Tomographic images and polar maps were generated with 20 segments. The standard deviation of percentage uptake of 20 segments (SD-uptake) as an index of heterogeneous MIBG uptake to the ventricular myocardium was calculated. We compared these MIBG-derived variables with the patients' clinical profiles, including ECG findings and hemodynamics. Eight of 24 patients had RVA (RVA group), and the other 16 did not have RVA (non-RVA group). There were no significant differences in the HMR (1.9 ± 0.5 vs. 2.2 ± 0.4) and WR (50 ± 5 vs. 42 ± 10) between the two groups. SD-uptake was significantly higher in the RVA group than in the non-RVA group (15 ± 3 vs. 12 ± 3, p = 0.03). QT dispersion (ms) was also higher in the RVA group than in the non-RVA group (53 ± 23 vs. 44 ± 18, p = 0.04). Multivariate logistic regression showed that SD-uptake and QT dispersion were independent predictors in the RVA group (p = 0.02, p = 0.03). In addition to greater QT dispersion, heterogeneous SNA is associated with RVA in TOF patients postoperatively.
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Ono
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan. hohuchi@ncvc.go.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohuchi
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Miyazaki
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kiso
authors.affiliation: Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamada
mesh_terms: D019797:3-Iodobenzylguanidine; D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging*; D002648:Child; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013771:Tetralogy of Fallot / Q000601:surgery*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
keywords: 123I metaiodobenzylguanidine; Scintigraphy; Sympathetic nervous activity; Tetralogy of Fallot; Ventricular arrhythmia