Assessment of 123I-mIBG and 99mTc-tetrofosmin single-photon emission computed tomographic images for the prediction of arrhythmic events in patients with ischemic heart failure: Intermediate severity innervation defects are associated with higher arrhythmic risk

Mark I. Travin, Milena J. Henzlova, Berthe L F van Eck-Smit, Diwakar Jain, Ignasi Carrió, Russell D. Folks, Ernest V. Garcia, Arnold F. Jacobson, Hein J. Verberne

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Rationale: 123I-mIBG planar image heart-to-mediastinum ratios effectively risk-stratify heart failure (HF) patients. The value of single-photon emission computed tomographic (SPECT) imaging for identifying increased risk of ventricular arrhythmias is less clear. This study sought to determine if findings from simultaneous interpretation of 123I-mIBG and 99mTc-tetrofosmin SPECT are predictive of arrhythmic events (ArEs). Methods: 123I-mIBG SPECT images from 622 patients with ischemic HF were presented in standard displays alongside 99mTc-tetrofosmin images. Consensus interpretations using a 17-segment model produced summed scores. Cox proportional hazards analyses related findings to adjudicated ArEs over 2 years. Results: 471 patients had images adequate for total 17-segment scoring. There were 48 ArEs (10.2%). Neither 123I-mIBG nor 99mTc-tetrofosmin SPECT summed scores were univariate predictors. On multivariate proportional hazards analysis, the 123I-mIBG SPECT score was independently predictive of ArEs (HR: 0.975, 95% CI 0.951-0.999, P = 0.042), but HR123I-mIBG SPECT score may not be correct as ischemic HF patients with abnormalities of intermediate extent appear at highest risk.

Original languageEnglish (US)
Pages (from-to)1-15
Number of pages15
JournalJournal of Nuclear Cardiology
DOIs
StateAccepted/In press - Jan 20 2016

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Photons
Heart Failure
Mediastinum
technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane
Cardiac Arrhythmias
Odds Ratio

Keywords

  • I-mIBG
  • arrhythmias
  • heart failure
  • SPECT

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Assessment of 123I-mIBG and 99mTc-tetrofosmin single-photon emission computed tomographic images for the prediction of arrhythmic events in patients with ischemic heart failure : Intermediate severity innervation defects are associated with higher arrhythmic risk. / Travin, Mark I.; Henzlova, Milena J.; van Eck-Smit, Berthe L F; Jain, Diwakar; Carrió, Ignasi; Folks, Russell D.; Garcia, Ernest V.; Jacobson, Arnold F.; Verberne, Hein J.

In: Journal of Nuclear Cardiology, 20.01.2016, p. 1-15.

Research output: Contribution to journalArticle

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abstract = "Rationale: 123I-mIBG planar image heart-to-mediastinum ratios effectively risk-stratify heart failure (HF) patients. The value of single-photon emission computed tomographic (SPECT) imaging for identifying increased risk of ventricular arrhythmias is less clear. This study sought to determine if findings from simultaneous interpretation of 123I-mIBG and 99mTc-tetrofosmin SPECT are predictive of arrhythmic events (ArEs). Methods: 123I-mIBG SPECT images from 622 patients with ischemic HF were presented in standard displays alongside 99mTc-tetrofosmin images. Consensus interpretations using a 17-segment model produced summed scores. Cox proportional hazards analyses related findings to adjudicated ArEs over 2 years. Results: 471 patients had images adequate for total 17-segment scoring. There were 48 ArEs (10.2{\%}). Neither 123I-mIBG nor 99mTc-tetrofosmin SPECT summed scores were univariate predictors. On multivariate proportional hazards analysis, the 123I-mIBG SPECT score was independently predictive of ArEs (HR: 0.975, 95{\%} CI 0.951-0.999, P = 0.042), but HR123I-mIBG SPECT score may not be correct as ischemic HF patients with abnormalities of intermediate extent appear at highest risk.",
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AU - Travin, Mark I.

AU - Henzlova, Milena J.

AU - van Eck-Smit, Berthe L F

AU - Jain, Diwakar

AU - Carrió, Ignasi

AU - Folks, Russell D.

AU - Garcia, Ernest V.

AU - Jacobson, Arnold F.

AU - Verberne, Hein J.

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