title: Preoperative iodine-123 meta-iodobenzylguanidine imaging is a novel predictor of left ventricular reverse remodeling during treatment with a left ventricular assist device.
abstract: Although left ventricular reverse remodeling (LVRR) is accompanied with an improved clinical course during LV assist device (LVAD) treatment, its preoperative prediction remains uncertain. Twenty-seven heart failure patients with dilated cardiomyopathy were enrolled in this study. Patients underwent (123)I-meta-iodobenzylguanidine (MIBG) scintigraphy before LVAD implantation, and were monitored at our institute from 2010 to 2014. This study investigated the prognostic value of preoperative (123)I-MIBG parameters for predicting postoperative LVRR. Of the preoperative variables studied, including (123)I-MIBG data, washout rate (WR) ≤ 39 % was the only significant, independent predictor of LVRR (defined as LV ejection fraction ≥35 % at 6 months post-LVAD implant using univariate and multivariate logistic regression analyses) (p = 0.036, odds ratio [OR]:14.45). Improved exercise capacity and more frequent opening of the native aortic valve, as well as lower B-type natriuretic peptide plasma levels, were observed in LVRR patients (p < 0.05 for all), although β-blocker doses were comparable with those of non-LVRR patients throughout the 6-month LVAD support period. In conclusion, preoperative (123)I-MIBG is a novel predictive tool of LVRR during LVAD support.
authors.affiliation: Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. imamurate-int@h.u-tokyo.ac.jp.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.affiliation: Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. kinugawa-tky@umin.ac.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8655, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nitta
authors.affiliation: Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8655, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.affiliation: Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8655, Japan.
authors.forename: Kan
authors.initials: K
authors.lastname: Nawata
authors.affiliation: Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, 113-8655, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020257:Ventricular Remodeling / Q000502:physiology*; D055815:Young Adult
chemical_list: D019797:3-Iodobenzylguanidine
keywords: Heart failure; Nuclear medicine; Washout rate