Usefulness of cardiac meta-iodobenzylguanidine imaging to identify patients with chronic heart failure and left ventricular ejection fraction <35% at low risk for Sudden cardiac death

Tsutomu Kawai, Takahisa Yamada, Shunsuke Tamaki, Takashi Morita, Yoshio Furukawa, Yusuke Iwasaki, Masato Kawasaki, Atsushi Kikuchi, Takumi Kondo, Satoshi Takahashi, Masashi Ishimi, Hideyuki Hakui, Tatsuhisa Ozaki, Yoshihiro Sato, Masahiro Seo, Yasushi Sakata, Masatake Fukunami

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11 Citations (Scopus)

Abstract

Patients with chronic heart failure (CHF) at risk of sudden cardiac death (SCD) are often treated with implantable cardiac defibrillators (ICDs). However, current criteria for device use that is based largely on left ventricular ejection fraction (LVEF) lead to many patients receiving ICDs that never deliver therapy. It is of clinical significance to identify patients who do not require ICDs. Although cardiac I-123 meta-iodobenzylguanidine (MIBG) imaging provides prognostic information about CHF, whether it can identify patients with CHF who do not require an ICD remains unclear. We studied 81 patients with CHF and LVEF <35%, assessed by cardiac MIBG imaging at enrollment. The heart-to-mediastinal ratio (H/M) in delayed images and washout rates were divided into 6 grades from 0 to 5, according to the degree of deviation from control values. The study patients were classified into 3 groups: low (1 to 4), intermediate (5 to 7), and high (8 to 10), according to the MIBG scores defined as the sum of the H/M and washout rate scores. Sixteen patients died of SCD during a follow-up period. Patients with low MIBG score had a significantly lower risk of SCD than those with intermediate and high scores (low [n = 19], 0%; intermediate [n = 37], 19%; high [n = 25], 36%; p = 0.001). The positive predictive value of low MIBG score for identifying patients without SCD was 100%. In conclusion, the MIBG score can identify patients with CHF and LVEF <35% who have low risk of developing SCD.

Original languageEnglish
Pages (from-to)1549-1554
Number of pages6
JournalAmerican Journal of Cardiology
Volume115
Issue number11
DOIs
Publication statusPublished - 01-06-2015

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Kawai, T., Yamada, T., Tamaki, S., Morita, T., Furukawa, Y., Iwasaki, Y., Kawasaki, M., Kikuchi, A., Kondo, T., Takahashi, S., Ishimi, M., Hakui, H., Ozaki, T., Sato, Y., Seo, M., Sakata, Y., & Fukunami, M. (2015). Usefulness of cardiac meta-iodobenzylguanidine imaging to identify patients with chronic heart failure and left ventricular ejection fraction <35% at low risk for Sudden cardiac death. American Journal of Cardiology, 115(11), 1549-1554. https://doi.org/10.1016/j.amjcard.2015.02.058