title: Prognostic Value of Cardiac Sympathetic Nerve Imaging Using Long-Term Follow-up Data - Ischemic vs. Non-Ischemic Heart Failure Etiology.
abstract: BACKGROUND
  Although there are several known prognostic determinants in heart failure (HF), individual risk profiles can vary, in particular between ischemic and non-ischemic HF background. This study investigated the difference in prognostic efficacy of cardiac (123)I-meta-iodobenzylguanidine (MIBG) imaging between the 2 etiologies.
  
  
  RESULTS
  All 1,322 patients with HF were enrolled and followed up at most after 10 years. The HF patients were divided into 2 groups: an ischemic group (n=362) and non-ischemic group (n=960), and Cox proportional hazards model was used for data analysis. During 10 years of follow-up, 296 (22.4%) of 1,322 patients died; the mortality rates were 21.8% and 22.6% for the ischemic and non-ischemic groups, respectively. The ischemic group had greater prevalence of sudden death and lethal acute myocardial infarction, and the non-ischemic group had a higher rate of pump failure death. On multivariate Cox proportional hazards analysis using categorized variables, in the ischemic group, delayed heart-to-mediastinum ratio (HMR; P<0.0001), age (P=0.0002) and LVEF (P=0.03) were the independent significant predictors of lethal events. In the non-ischemic group, delayed HMR (P<0.0001), NYHA class (P<0.0001) and age (P<0.0001) were significant determinants of lethal outcome.
  
  
  CONCLUSIONS
  Cardiac MIBG imaging has nearly identical prognostic value in both ischemic and non-ischemic HF, independent of cause of cardiac death.
authors.affiliation: Department of Nuclear Medicine, Kanazawa University Hospital.
authors.forename: Shinro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakajima
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nakata
mesh_terms: D019797:3-Iodobenzylguanidine / Q000008:administration & dosage*; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D059906:Neuroimaging; D011446:Prospective Studies; D015996:Survival Rate; D013564:Sympathetic Nervous System / Q000473:pathology / Q000503:physiopathology
chemical_list: D019797:3-Iodobenzylguanidine