title: Prediction of all-cause death using (11)C-hydroxyephedrine positron emission tomography in Japanese patients with left ventricular dysfunction.
abstract: OBJECTIVE
  The aim of this study was to determine whether (11)C-hydroxyephedrine ((11)C-HED) can predict adverse events including all-cause death in Japanese patients with left ventricular (LV) dysfunction.
  
  
  BACKGROUND
  Although (11)C-HED PET has been used to assess cardiac sympathetic innervation in various disease conditions, data on their prognostic value are limited.
  
  
  METHODS
  Sixty patients (mean LVEF, 42 ± 14 %) with LV dysfunction (42 ischemic and 18 non-ischemic heart disease) underwent (11)C-HED PET. Myocardial retention was calculated for (11)C-HED PET as a measure of cardiac sympathetic neuronal integrity. Statistical analysis was performed using Cox proportional hazards regression and log-rank test.
  
  
  RESULTS
  Thirteen deaths (7 cardiac and 6 non-cardiac deaths) occurred during a mean follow-up period of 33 ± 23 months. The patients with death were associated with significantly lower (11)C-HED retention (7.1 ± 2.1 vs 9.0 ± 2.4, p = 0.015) than those without death. The hazard ratio for global (11)C-HED retention per unit (/min) was 0.762 (p = 0.039), which remained significant in multivariate analysis. When the patients were divided into the high (≥8.5) and low (<8.5) (11)C-HED retention groups, the low (11)C-HED retention group was associated with significantly poorer survival than the high (11)C-HED retention group (p = 0.004).
  
  
  CONCLUSIONS
  The low global (11)C-HED retention is a marker of poor overall survival in patients with LV dysfunction in this study.
authors.affiliation: Department of Cardiology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Fujita
authors.affiliation: The Medical and Pharmacological Research Center Foundation, Ishikawa, Japan. m_ichoro@saitama-med.ac.jp.|Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, 38 Morohongo, Moroyama, Iruma, Saitama, 350-0495, Japan. m_ichoro@saitama-med.ac.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Matsunari
authors.affiliation: Department of Cardiology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Aoki
authors.affiliation: Department of Nuclear Medicine, Technical University Munich, Munich, Germany.
authors.forename: Stephan G
authors.initials: SG
authors.lastname: Nekolla
authors.affiliation: Department of Cardiology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan. kajinami@kanazawa-med.ac.jp.
authors.forename: Kouji
authors.initials: K
authors.lastname: Kajinami
mesh_terms: D000328:Adult; D000368:Aged; D023381:Endpoint Determination; D004809:Ephedrine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality*
chemical_list: D004809:Ephedrine
keywords: Nervous system; Radioisotopes; Sympathetic; Tomography