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首页> 外文期刊>The Journal of Nuclear Medicine >Prognostic Value of Serial Cardiac 123I-MIBG Imaging in Patients with Stabilized Chronic Heart Failure and Reduced Left Ventricular Ejection Fraction
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Prognostic Value of Serial Cardiac 123I-MIBG Imaging in Patients with Stabilized Chronic Heart Failure and Reduced Left Ventricular Ejection Fraction

机译：连续性心脏123I-MIBG成像对稳定的慢性心力衰竭和左心室射血分数降低的患者的预后价值

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id="p-1">Many studies have shown that a one-time 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphic study during a stable period is useful for determining the prognosis of patients with chronic heart failure (CHF). However, the findings from this imaging modality are well known to be improved by medical treatment for heart failure. Accordingly, this study was performed to determine whether serial 123I-MIBG scintigraphic studies represent a reliable prognostic marker for patients with CHF. >Methods: A total of 208 patients with CHF (left ventricular ejection fraction [LVEF] 45%) and with no cardiac events for at least 5 mo were identified on the basis of a history of decompensated acute heart failure requiring hospitalization. The delayed percentage of denervation (% denervation), delayed heart-to-mediastinum count (H/M) ratio, and washout rate (WR) were determined from the patients' 123I-MIBG images just before they left the hospital and after they had received 6 mo of treatment. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and LVEF were also determined by echocardiography at the same time points. >Results: Of the 208 patients, 56 experienced fatal cardiac events during the study. The mean follow-up period was 4.45 ?± 1.82 y. The baseline H/M ratio and WR; follow-up % denervation, H/M ratio, and WR; ?”-% denervation, H/M ratio, and WR; baseline LVEF; follow-up LVEDV, LVESV, and LVEF; and ?”-LVEDV, ?”-LVESV, and ?”-LVEF were significantly worse in the cardiac death group. A Cox regression analysis showed that the ?”-WR was an independent predictor of cardiac death. Moreover, sudden death occurred in 13 of the 56 patients with cardiac death. A Cox regression analysis also showed that the ?”-WR was an incremental predictor of sudden death. The cardiac death-free rate and sudden death-free rate were significantly higher in patients with ?”-WR less than a?’5% and ?”-WR less than a?’2% than in patients with ?”-WR greater than or equal to a?’5% and ?”-WR greater than or equal to a?’2%. >Conclusion: ?”-WR obtained from serial 123I-MIBG scintigraphic studies can be useful for predicting cardiac death and sudden death in stabilized patients with CHF.
机译：id =“ p-1”>许多研究表明，在稳定时期内进行的一次 123 I-甲基碘苄胍（ 123 I-MIBG）闪烁扫描可用于确定慢性心力衰竭（CHF）患者的预后。然而，众所周知，通过心力衰竭的医学治疗可以改善这种成像方式的发现。因此，本研究旨在确定连续的 123 I-MIBG闪烁显像研究是否代表CHF患者的可靠预后指标。 >方法：根据失代偿的急性心脏病史，总共确定了208例CHF（左心室射血分数[LVEF] <45％）且无心脏事件且至少5 mo的患者失败，需要住院。从患者的 123 I-MIBG图像中确定去神经延迟百分比（去神经百分比），延迟的心-纵隔计数（H / M）比和清除率（WR）他们离开医院，接受了6个月的治疗。左心室舒张末期容积（LVEDV），左心室收缩末期容积（LVESV）和LVEF也在同一时间点通过超声心动图确定。 >结果：在208位患者中，有56位在研究期间经历了致命的心脏事件。平均随访时间为4.45±1.82 y。基线H / M比和WR;随访的去神经％，H / M比和WR; ？”-去神经率，H / M比和WR; LVEF基线;随访LVEDV，LVESV和LVEF;在心脏死亡组中，β-LVEDV，β-LVESV和β-LVEF显着恶化。 Cox回归分析表明，β-WR是心源性死亡的独立预测因子。此外，在56例心源性死亡患者中，有13例猝死。 Cox回归分析还显示，β” -WR是猝死的增量预测因子。 ≥α？-WR小于a？'5％的患者和??-WR小于a？'2％的患者的心脏无死亡率和猝死率显着高于??-WR的患者大于或等于a′′5％，而α″ -WR大于或等于a′′2％。 >结论：？”-WR是从 123 I-MIBG闪烁显像研究获得的，可用于预测稳定的CHF患者的心源性死亡和猝死。

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