Impact of aging on cardiac sympathetic innervation measured by123I-mIBG imaging in patients with systolic heart failure.
OBJECTIVE
Sympathetic nervous system (SNS) hyperactivity is a salient characteristic of chronic heart failure (HF) and contributes to the progression of the disease. Iodine-123 meta-iodobenzylguanidine (123I-mIBG) imaging has been successfully used to assess cardiac SNS activity in HF patients and to predict prognosis. Importantly, SNS hyperactivity characterizes also physiological ageing, and there is conflicting evidence on cardiac123I-mIBG uptake in healthy elderly subjects compared to adults. However, little data are available on the impact of ageing on cardiac sympathetic nerve activity assessed by123I-mIBG scintigraphy, in patients with HF.


RESULTS
We studied 180 HF patients (age = 66.1 ± 10.5 years [yrs]), left ventricular ejection fraction (LVEF = 30.6 ± 6.3 %) undergoing cardiac123I-mIBG imaging. Early and late heart to mediastinum (H/M) ratios and washout rate were calculated in all patients. Demographic, clinical, and echocardiographic data were also collected. Our study population consisted of 53 patients aged >75 years (age = 77.7 ± 4.0 year), 67 patients aged 62-72 years (age = 67.9 ± 3.2 years) and 60 patients aged ≤61 year (age = 53.9 ± 5.6 years). In elderly patients, both early and late H/M ratios were significantly lower compared to younger patients (p < 0.05). By multivariate analysis, H/M ratios (both early and late) and washout rate were significantly correlated with LVEF and age.


CONCLUSIONS
Our data indicate that, in a population of HF patients, there is an independent age-related effect on cardiac SNS innervation assessed by123I-mIBG imaging. This finding suggests that cardiac123I-mIBG uptake in patients with HF might be affected by patient age.
Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Telese Terme, Italy.|Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Giuseppe
G
Rengo
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Gennaro
G
Pagano
Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Telese Terme, Italy.
Dino Franco
DF
Vitale
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Roberto
R
Formisano
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Klara
K
Komici
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Laura
L
Petraglia
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Valentina
V
Parisi
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Grazia Daniela
GD
Femminella
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Claudio
C
de Lucia
SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy.
Stefania
S
Paolillo
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Alessandro
A
Cannavo
Department of Cardiology, Fatebenefratelli Hospital, Naples, Italy.
Emilio
E
Attena
Institute of Biostructures and Bioimages of the National Council of Research, Naples, Italy.|Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
Teresa
T
Pellegrino
Division of Cardiology, Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, Acerra, Naples, Italy.
Santo
S
Dellegrottaglie
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Alessia
A
Memmi
Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
Bruno
B
Trimarco
SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy.|Division of Imaging, Radiotherapy, Neuroradiology, and Medical Physics, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
Alberto
A
Cuocolo
Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
Pasquale Perrone
PP
Filardi
Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy. dleosco@unina.it.
Dario
D
Leosco
Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Telese Terme, Italy.|Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Via Sergio Pansini, 5, -80131, Naples, Italy.
Nicola
N
Ferrara
D019797:3-Iodobenzylguanidine; D000368:Aged; D000375:Aging; D057791:Cardiac Imaging Techniques / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
123I-mIBG imaging; Age; Heart failure; Norepinephrine; Sympathetic nervous system