Prognostic values of 123 I-MIBG myocardial scintigraphy and heart rate variability in patients with heart failure with preserved ejection fraction

• Published in: Journal of nuclear cardiology 2020-06, Vol.27 (3), p.833
• Main Authors: Hashimoto, Hidenobu, Nakanishi, Rine, Mizumura, Sunao, Hashimoto, Yukiko, Okamura, Yuriko, Yamanaka, Kyoko, Yamazaki, Junichi, Ikeda, Takanori
• Format: Article
• Language: English
• Subjects: 3-Iodobenzylguanidine; Aged; Echocardiography - methods; Female; Heart Failure - diagnostic imaging; Heart Rate; Humans; Iodine Radioisotopes; Kaplan-Meier Estimate; Male; Middle Aged; Myocardial Perfusion Imaging - methods; Prognosis; Proportional Hazards Models; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Stroke Volume; Sympathetic Nervous System - physiopathology; Treatment Outcome; Ventricular Dysfunction, Left - diagnostic imaging
• ISSN: 1532-6551
• DOI: 10.1007/s12350-018-01494-x

The aim of this study was to evaluate the prognostic values of sympathetic nerve system using I-MIBG myocardial scintigraphy and using Holter electrocardiogram (ECG) in patients with heart failure with preserved ejection fraction (HFpEF). Among 403 consecutive patients with stable HF who underwent I-MIBG myocardial scintigraphy and Holter ECG, we identified 133 patients (64 ± 16 years) who had preserved ejection fraction (≥ 50%) by echocardiography. Multivariate Cox model was used to assess if washout rate (WR) by I-MIBG scintigraphy and very low frequency power (VLFP) by Holter ECG was associated with major adverse cardiovascular events (MACE). During a mean follow-up of 5.4 ± 4.1 years, 39 MACE occurred. The lower nighttime VLFP (HR 3.29, 95% CI 1.56 to 6.92) and higher WR (HR 4.01, 95% CI 1.63 to 9.88) were the significant prognostic factors for MACE. As compared to high nighttime VLFP and low WR group, MACE risk was significantly the highest in the low nighttime VLFP and high WR group (HR 40.832; 95% CI 5.378 to 310.012, P