Advances in Imaging of the Cardiac Neuronal System |
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Authors: | Mouhamad Abdallah Myron C Gerson |
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Institution: | 1.Division of Cardiovascular Diseases, Department of Internal Medicine,University of Cincinnati College of Medicine,Cincinnati,USA;2.E. L. Saenger Radioisotope Laboratory, Department of Radiology,University of Cincinnati College of Medicine,Cincinnati,USA |
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Abstract: | Left ventricular ejection fraction (LVEF) is a useful tool for stratifying risk for heart failure progression and life-threatening
arrhythmic events. Yet, the clinical course of heart failure patients with severely reduced LVEF is variable, and the majority
of patients who die suddenly do not have an LVEF ≤35%. A recently completed large multicenter trial, ADMIRE-HF, confirms that
cardiac neuronal imaging with I-123 metaiodobenzylguanidine is an important independent predictor of heart failure progression
and sudden cardiac death. Data from that study indicate that heart failure patients with severe impairment of cardiac sympathetic
innervation are at highest risk for heart failure progression, heart failure patients with moderate impairment of sympathetic
innervation are at highest risk for life-threatening arrhythmic events, and heart failure patients with preserved sympathetic
innervation are at low risk for either death due to heart failure progression or sudden cardiac death. |
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