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- Title
Assessment of <sup>123</sup>I-mIBG and <sup>99m</sup>Tc-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.
- Authors
Travin, Mark; Henzlova, Milena; Eck-Smit, Berthe; Jain, Diwakar; Carrió, Ignasi; Folks, Russell; Garcia, Ernest; Jacobson, Arnold; Verberne, Hein; Travin, Mark I; Henzlova, Milena J; van Eck-Smit, Berthe L F; Carrió, Ignasi; Folks, Russell D; Garcia, Ernest V; Jacobson, Arnold F; Verberne, Hein J
- Abstract
<bold>Rationale: </bold>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).<bold>Methods: </bold>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.<bold>Results: </bold>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 HR<1 indicated that risk decreased with increasing score. This occurred because patients with intermediately abnormal SPECT studies had a higher likelihood of ArEs compared to patients with extensive abnormalities.<bold>Conclusions: </bold>The presumption of a monotonic increase in ArE risk with increasing summed 123I-mIBG SPECT score may not be correct as ischemic HF patients with abnormalities of intermediate extent appear at highest risk.
- Subjects
SINGLE-photon emission computed tomography; COMPUTED tomography; ARRHYTHMIA; HEART failure; CORONARY disease
- Publication
Journal of Nuclear Cardiology, 2017, Vol 24, Issue 2, p377
- ISSN
1071-3581
- Publication type
journal article
- DOI
10.1007/s12350-015-0336-8