التفاصيل البيبلوغرافية
| العنوان: |
I-123- mIBG myocardial imaging for assessment of risk for a major cardiac event in heart failure patients: insights from a retrospective European multicenter study. |
| المؤلفون: |
Agostini, Denis1 agostini-de@chu-caen.fr, Verberne, Hein J.2, Burchert, Wolfgang3, Knuuti, Juhani4, Povinec, Pavol5, Sambuceti, Gianmario6, Unlu, Mustafa7, Estorch, Montserrat8, Banerjee, Gopa9, Jacobson, Arnold F.9 |
| المصدر: |
European Journal of Nuclear Medicine & Molecular Imaging. Mar2008, Vol. 35 Issue 3, p535-546. 12p. 1 Black and White Photograph, 4 Charts, 5 Graphs. |
| مصطلحات موضوعية: |
*HEART failure, *MIBG (Chemical), *CLINICAL trials, *LEFT heart ventricle, *ARRHYTHMIA, *MEDIASTINUM, *DIAGNOSIS |
| مصطلحات جغرافية: |
EUROPE |
| مستخلص: |
Single-center experiences have shown that myocardial meta-iodobenzylguanidine ( mIBG) uptake has prognostic value in heart failure (HF) patients. To verify these observations using a rigorous clinical trial methodology, a retrospective review and prospective quantitative reanalysis was performed on a series of cardiac 123I- mIBG scans acquired during a 10-year period at six centers in Europe. 123I- mIBG scans obtained on 290 HF patients [(262 with left ventricular ejection fraction (LVEF) < 50%)] from 1993 to 2002 were reanalyzed using a standardized methodology to determine the heart-to-mediastinum ratio (H/M) on delayed planar images. All image results were verified by three independent reviewers. Major cardiac events [MCEs; cardiac death, cardiac transplant, potentially fatal arrhythmia (including implantable cardioverter-defibrillator discharge)] during 24-month follow-up were confirmed by an adjudication committee. MCEs occurred in 67 patients (26%): mean H/M ratio was 1.51 ± 0.30 for the MCE group and 1.97 ± 0.54 for the non-MCE group ( p < 0.001). Two-year event-free survival using an optimum H/M ratio threshold of 1.75 was 62% for H/M ratio less than 1.75, 95% for H/M ratio greater than or equal to 1.75 ( p < 0.0001). Logistic regression showed H/M ratio and LVEF as the only significant predictors of MCE. Using the lower and upper H/M quartiles of 1.45 and 2.17 as high- and very low-risk thresholds, 2-year event-free survival rates were 52% and 98%, respectively. Among patients with LVEF ≤ 35% and H/M ≥ 1.75 ( n = 73), there were nine MCEs because of progressive HF and only one because of an arrhythmia. Application of a clinical trial methodology via the retrospective reanalysis of 123I- mIBG images confirms the previously reported prognostic value of this method in HF patients, including potential identification of a quantitative threshold for low risk for cardiac mortality and potentially fatal ventricular arrhythmias. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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