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- Title
Relationship between quantitative cardiac neuronal imaging with I- meta-iodobenzylguanidine and hospitalization in patients with heart failure.
- Authors
Parker, Matthew; Sood, Nitesh; Ahlberg, Alan; Jacobson, Arnold; Heller, Gary; Lundbye, Justin
- Abstract
Purpose: Hospitalization in patients with systolic heart failure is associated with morbidity, mortality, and cost. Myocardial sympathetic innervation, imaged by I- meta-iodobenzylguanidine (I-mIBG), has been associated with cardiac events in a recent multicenter study. The present analysis explored the relationship between I-mIBG imaging findings and hospitalization. Methods: Source documents from the ADMIRE-HF trial were reviewed to identify hospitalization events in patients with systolic heart failure following cardiac neuronal imaging using I-mIBG. Time to hospitalization was analyzed with the Kaplan-Meier method and compared to the mIBG heart-to-mediastinum (H/M) ratio using multiple-failure Cox regression. Results: During 1.4 years of median follow-up, 362 end-point hospitalizations occurred in 207 of 961 subjects, 79 % of whom had H/M ratio <1.6. Among subjects hospitalized for any cause, 88 % had H/M ratio <1.6 and subjects with H/M ratio <1.6 experienced hospitalization earlier than subjects with higher H/M ratios (log-rank p = 0.003). After adjusting for elevated brain natriuretic peptide (BNP) and time since heart failure diagnosis, a low mIBG H/M ratio was associated with cardiac-related hospitalization (HR 1.48, 95 % CI 1.05 - 2.0; p = 0.02). Conclusion: The mIBG H/M ratio may risk-stratify patients with heart failure for cardiac-related hospitalization, especially when used in conjunction with BNP. Further studies are warranted to examine these relationships.
- Subjects
HEART failure patients; HOSPITAL care; CARDIAC imaging; KAPLAN-Meier estimator; BRAIN natriuretic factor
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2014, Vol 41, Issue 9, p1666
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-014-2819-2