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Journal of Nuclear Cardiology

, Volume 26, Issue 1, pp 109–117 | Cite as

Prediction of sudden cardiac death in patients with chronic heart failure by regional washout rate in cardiac MIBG SPECT imaging

  • Hironori Yamamoto
  • Takahisa YamadaEmail author
  • Shunsuke Tamaki
  • Takashi Morita
  • Yoshio Furukawa
  • Yusuke Iwasaki
  • Masato Kawasaki
  • Atsushi Kikuchi
  • Takumi Kondo
  • Tatsuhisa Ozaki
  • Masahiro Seo
  • Yoshihiro Sato
  • Iyo Ikeda
  • Eiji Fukuhara
  • Makoto Abe
  • Jun Nakamura
  • Masatake Fukunami
Original Article

Abstract

Background

The sympathetic nervous system provides an important trigger for major arrhythmic events through regional heterogeneity of sympathetic activity, which could be evaluated by SPECT imaging as the regional MIBG washout rate (WR). There is little information available on the prognostic value of regional WR in SPECT imaging for the prediction of sudden cardiac death (SCD) in patients with chronic heart failure (CHF).

Methods

We studied 73 CHF outpatients with LVEF < 40%. At study entry, the regional WR was measured in 17 segments on the polar map. We defined abnormal regional WR as both the regional WR range (maximum − minimum regional WR) and maximum regional WR > mean value + 2SD obtained in 15 normal controls.

Results

During a mean follow-up of 7.5 ± 4.1 years, 15 of 73 patients had SCD. The abnormal regional WR and abnormal global WR on planar images were significantly and independently associated with SCD. Patients with both the abnormal regional WR and global WR had a significantly higher risk of SCD than those with none of these criteria.

Conclusions

The analysis of regional MIBG WR on SPECT imaging provides additional prognostic value to global WR on planar images for SCD prediction in CHF patients.

Keywords

MIBG imaging heart failure SPECT 

Abbreviations

SPECT

Single-photon emission computed tomography

MIBG

Meta-iodobenzylguanidine

WR

Washout rate

SCD

Sudden cardiac death

CHF

Chronic heart failure

LVEF

Left ventricular ejection fraction

ICD

Implantable cardioverter defibrillator

HMR

Heart-to-mediastinum ratio

SES

Summed extent score

SSS

Summed severity score

Notes

Disclosure

No financial or other relationships that could lead to a conflict of interest are associated with this study.

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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Hironori Yamamoto
    • 1
  • Takahisa Yamada
    • 1
    Email author
  • Shunsuke Tamaki
    • 1
  • Takashi Morita
    • 1
  • Yoshio Furukawa
    • 1
  • Yusuke Iwasaki
    • 1
  • Masato Kawasaki
    • 1
  • Atsushi Kikuchi
    • 1
  • Takumi Kondo
    • 1
  • Tatsuhisa Ozaki
    • 1
  • Masahiro Seo
    • 1
  • Yoshihiro Sato
    • 1
  • Iyo Ikeda
    • 1
  • Eiji Fukuhara
    • 1
  • Makoto Abe
    • 1
  • Jun Nakamura
    • 1
  • Masatake Fukunami
    • 1
  1. 1.Division of CardiologyOsaka General Medical CenterOsakaJapan

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