111 Prognostic value of cardiac metaiodobenzylguanidine in patients with advanced heart failure: relationship with peak oxygen consumption and brain natriuretic peptide

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• 作者：Fabien Despas¹ ; Mathieu Alonso² ; Remy Cagnac³ ; Michel Galinier⁴ ; Jean Michel Senard¹ ; Atul Pathak¹
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2010
• 出版时间：January 2010
• 年：2010
• 卷：2
• 期：1
• 页码：37
• 全文大小：78 K

文摘

Objectives

We sought to prospectively compare the prognostic value of cardiac iodine-123 (I-123) metaiodobenzylguanidine (MIBG) imaging with peak oxygen comsumption (VO2) and plasma BNP level in patients with advanced heart failure (AHF) waiting for heart transplant.

Bakground

In mild to moderate heart failure, cardiac fixation of MIBG reflecting presynaptic uptake is reduced, exercise capacity is altered and plasma BNP level is increased. In AHF prognostic value of these parameters is still unknown.

Methods

Fifty one patients with advanced heart failure were studied with planar MIBG imaging, cardiopulmonary exercise tests, hemodynamic and neurohormonal parameters. Early (30 min) and late (4 h) MIBG acquisition, as well as their ratio (washout rate, WOR) were determined. Prognostic value was assessed by survival curves (Kaplan-Meier method) and uni- and multivariate Cox analyses.

Results

Early and late cardiac MIBG uptake were correlated with ejection fraction (r=0.33 and r=0.42). With a median follow up of 494 days, NYHA (p=0.03), plasma BNP (p=0.002), peak VO2 (p=0.03) were predictive of death or heart transplantation, but only plasma BNP emerged by multivariate analysis. WOR>36.63 % (1^st quartile) was predictive on kaplan-Meier analysis.

Conclusions

In AHF patients, VO2 and BNP plasma level are stronger prognosticator than MIBG imaging related parameters. MIBG should be reserved to patients with mild to moderate heart failure while BNP remains the most powerful prognostic index whatever the severity of heart failure.