Prognostic usefulness of planar 123I-MIBG scintigraphic images of myocardial sympathetic innervation in congestive heart failure: Follow-Up data from ADMIRE-HF

on behalf of the ADMIRE-HF investigators

Research output: Contribution to journalArticle

Abstract

Background: To evaluate whether planar 123I-MIBG myocardial scintigraphy predicts risk of death in heart failure (HF) patients up to 5 years after imaging. Methods and Results: Subjects from ADMIRE-HF were followed for approximately 5 years after imaging (964 subjects, median follow-up 62.7 months). Subjects were stratified according to the heart/mediastinum (H/M) ratio (< 1.60 vs ≥ 1.60) on planar 123I-MIBG scintigraphic images obtained at baseline in ADMIRE-HF. Cox proportional hazards models and Kaplan-Meier analyses were used to evaluate time to death, cardiac death, or arrhythmic events for subjects stratified by H/M ratio, baseline left ventricular ejection fraction (LVEF: < 25% and 25 to ≤ 35%), and by H/M strata within LVEF strata. All-cause mortality was 38.4% vs 20.9% and cardiac mortality was 16.8% vs 4.5%, in subjects with H/M < 1.60 vs ≥ 1.60, respectively (P < 0.05 for both comparisons). Subjects with preserved sympathetic innervation of the myocardium (H/M ≥ 1.60) were at significantly lower risk of all-cause and cardiac death, arrhythmic events, sudden cardiac death, or potentially life-threatening arrhythmias. Within LVEF strata, a trend toward a higher mortality for subjects with H/M < 1.60 was observed reaching significance for LVEF 25 to ≤ 35% only. Conclusions: During a median follow-up of 62.7 months, patients with H/M ≥ 1.60 were at significantly lower risk of death and arrhythmic events independently of LVEF values.

Original languageEnglish (US)
JournalJournal of Nuclear Cardiology
DOIs
StateAccepted/In press - Jan 1 2019

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3-Iodobenzylguanidine
Mediastinum
Heart Failure
Mortality
Myocardial Perfusion Imaging
Sudden Cardiac Death
Kaplan-Meier Estimate
Proportional Hazards Models
Stroke Volume
Cardiac Arrhythmias
Cause of Death
Myocardium

Keywords

  • I-MIBG
  • cardiac death
  • congestive heart failure
  • prognosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{3d078bef395e47ab978ca04d5bfb7534,
title = "Prognostic usefulness of planar 123I-MIBG scintigraphic images of myocardial sympathetic innervation in congestive heart failure: Follow-Up data from ADMIRE-HF",
abstract = "Background: To evaluate whether planar 123I-MIBG myocardial scintigraphy predicts risk of death in heart failure (HF) patients up to 5 years after imaging. Methods and Results: Subjects from ADMIRE-HF were followed for approximately 5 years after imaging (964 subjects, median follow-up 62.7 months). Subjects were stratified according to the heart/mediastinum (H/M) ratio (< 1.60 vs ≥ 1.60) on planar 123I-MIBG scintigraphic images obtained at baseline in ADMIRE-HF. Cox proportional hazards models and Kaplan-Meier analyses were used to evaluate time to death, cardiac death, or arrhythmic events for subjects stratified by H/M ratio, baseline left ventricular ejection fraction (LVEF: < 25{\%} and 25 to ≤ 35{\%}), and by H/M strata within LVEF strata. All-cause mortality was 38.4{\%} vs 20.9{\%} and cardiac mortality was 16.8{\%} vs 4.5{\%}, in subjects with H/M < 1.60 vs ≥ 1.60, respectively (P < 0.05 for both comparisons). Subjects with preserved sympathetic innervation of the myocardium (H/M ≥ 1.60) were at significantly lower risk of all-cause and cardiac death, arrhythmic events, sudden cardiac death, or potentially life-threatening arrhythmias. Within LVEF strata, a trend toward a higher mortality for subjects with H/M < 1.60 was observed reaching significance for LVEF 25 to ≤ 35{\%} only. Conclusions: During a median follow-up of 62.7 months, patients with H/M ≥ 1.60 were at significantly lower risk of death and arrhythmic events independently of LVEF values.",
keywords = "I-MIBG, cardiac death, congestive heart failure, prognosis",
author = "{on behalf of the ADMIRE-HF investigators} and Denis Agostini and Karthikeyan Ananthasubramaniam and Harish Chandna and Lars Friberg and Andrew Hudnut and Michael Koren and Miyamoto, {Michael I.} and Roxy Senior and Mahesh Shah and Travin, {Mark I.} and Dahl, {J{\"u}rgen vom} and Kun Chen and Levy, {Wayne C.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s12350-019-01859-w",
language = "English (US)",
journal = "Journal of Nuclear Cardiology",
issn = "1071-3581",
publisher = "Springer New York",

}

TY - JOUR

T1 - Prognostic usefulness of planar 123I-MIBG scintigraphic images of myocardial sympathetic innervation in congestive heart failure

T2 - Follow-Up data from ADMIRE-HF

AU - on behalf of the ADMIRE-HF investigators

AU - Agostini, Denis

AU - Ananthasubramaniam, Karthikeyan

AU - Chandna, Harish

AU - Friberg, Lars

AU - Hudnut, Andrew

AU - Koren, Michael

AU - Miyamoto, Michael I.

AU - Senior, Roxy

AU - Shah, Mahesh

AU - Travin, Mark I.

AU - Dahl, Jürgen vom

AU - Chen, Kun

AU - Levy, Wayne C.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: To evaluate whether planar 123I-MIBG myocardial scintigraphy predicts risk of death in heart failure (HF) patients up to 5 years after imaging. Methods and Results: Subjects from ADMIRE-HF were followed for approximately 5 years after imaging (964 subjects, median follow-up 62.7 months). Subjects were stratified according to the heart/mediastinum (H/M) ratio (< 1.60 vs ≥ 1.60) on planar 123I-MIBG scintigraphic images obtained at baseline in ADMIRE-HF. Cox proportional hazards models and Kaplan-Meier analyses were used to evaluate time to death, cardiac death, or arrhythmic events for subjects stratified by H/M ratio, baseline left ventricular ejection fraction (LVEF: < 25% and 25 to ≤ 35%), and by H/M strata within LVEF strata. All-cause mortality was 38.4% vs 20.9% and cardiac mortality was 16.8% vs 4.5%, in subjects with H/M < 1.60 vs ≥ 1.60, respectively (P < 0.05 for both comparisons). Subjects with preserved sympathetic innervation of the myocardium (H/M ≥ 1.60) were at significantly lower risk of all-cause and cardiac death, arrhythmic events, sudden cardiac death, or potentially life-threatening arrhythmias. Within LVEF strata, a trend toward a higher mortality for subjects with H/M < 1.60 was observed reaching significance for LVEF 25 to ≤ 35% only. Conclusions: During a median follow-up of 62.7 months, patients with H/M ≥ 1.60 were at significantly lower risk of death and arrhythmic events independently of LVEF values.

AB - Background: To evaluate whether planar 123I-MIBG myocardial scintigraphy predicts risk of death in heart failure (HF) patients up to 5 years after imaging. Methods and Results: Subjects from ADMIRE-HF were followed for approximately 5 years after imaging (964 subjects, median follow-up 62.7 months). Subjects were stratified according to the heart/mediastinum (H/M) ratio (< 1.60 vs ≥ 1.60) on planar 123I-MIBG scintigraphic images obtained at baseline in ADMIRE-HF. Cox proportional hazards models and Kaplan-Meier analyses were used to evaluate time to death, cardiac death, or arrhythmic events for subjects stratified by H/M ratio, baseline left ventricular ejection fraction (LVEF: < 25% and 25 to ≤ 35%), and by H/M strata within LVEF strata. All-cause mortality was 38.4% vs 20.9% and cardiac mortality was 16.8% vs 4.5%, in subjects with H/M < 1.60 vs ≥ 1.60, respectively (P < 0.05 for both comparisons). Subjects with preserved sympathetic innervation of the myocardium (H/M ≥ 1.60) were at significantly lower risk of all-cause and cardiac death, arrhythmic events, sudden cardiac death, or potentially life-threatening arrhythmias. Within LVEF strata, a trend toward a higher mortality for subjects with H/M < 1.60 was observed reaching significance for LVEF 25 to ≤ 35% only. Conclusions: During a median follow-up of 62.7 months, patients with H/M ≥ 1.60 were at significantly lower risk of death and arrhythmic events independently of LVEF values.

KW - I-MIBG

KW - cardiac death

KW - congestive heart failure

KW - prognosis

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UR - http://www.scopus.com/inward/citedby.url?scp=85071415151&partnerID=8YFLogxK

U2 - 10.1007/s12350-019-01859-w

DO - 10.1007/s12350-019-01859-w

M3 - Article

AN - SCOPUS:85071415151

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

SN - 1071-3581

ER -