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首页> 外文期刊>World Journal of Nuclear Science and Technology >Is There an Incremental Prognostic Value of Evaluating Left Ventricular Dyssynchrony by Gated SPECT in Patients with Systolic Heart Failure and Altered Myocardial Sympathetic Innervation as Evaluated by Cardiac I-123 mIBG Imaging?
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Is There an Incremental Prognostic Value of Evaluating Left Ventricular Dyssynchrony by Gated SPECT in Patients with Systolic Heart Failure and Altered Myocardial Sympathetic Innervation as Evaluated by Cardiac I-123 mIBG Imaging?

机译：通过门控SPECT评估左心室不同步性对心脏I-123 mIBG成像所评估的收缩性心力衰竭和心肌交感神经改变的患者是否具有增加的预后价值？

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Background: Altered myocardial sympathetic innervation activity (AMSI) is known to be present in systolic heart failure patients (SHF) and recently SPECT imaging using I-123 mIBG heart to mediastinum (H/M) ratio and LVMD collectively affect clinical outcomes and other cardiovascular parameters. Objectives: The objectives are to examine the clinical characteristics and incremental prognostic value for MACE of LVMD determined by SPECT in SHF patients with or without abnormal cardiac MIBG uptake (H/M ratio tion both of which assess the extent of dispersion of LV activation during contraction as a marker of LVMD. Patients were followed up for a mean period of 6 years. The primary end point was mortality from any cause and secondary end point was heart failure admission or myocardial infarction or ICD shock. Results: 2 Groups were defined: Group A: n = 17 with H/M MIBG ratio ?LVMD. Baseline characteristics, cardiac risk factors and medications were comparable between both groups. LVEF was lower and RBBB was less common in Group A. There was no statistical difference in achievement of primary or secondary end points in the two groups including death heart failure readmissions, ICD shocks or MI. Conclusions: In our pilot study, we did not find definitive value of adding SPECT based LVMD to abnormal cardiac MIBG imaging in SHF patients with regards to predicting outcomes. Although our sample size is too small to make any definitive conclusions, it is possible that LVMD works independently through different pathways in the progression of SHF and hence may not necessarily add incremental value to AMSI determination using MIBG.
机译：背景：已知在收缩期心力衰竭患者（SHF）中存在改变的心肌交感神经支配活动（AMSI），最近使用I-123 mIBG心与纵隔（H / M）和LVMD的SPECT成像共同影响临床结果和其他心血管疾病参数。目的：目的是检查通过SPECT测定的有或无心脏MIBG摄取异常（S / H / M比）的SHF患者LVSP的临床特征和LVMD MACE的增加预后价值（两者均评估收缩过程中LV活化分散的程度） LVMD是LVMD的标志物，患者平均随访6年，主要终点为任何原因的死亡率，次要终点为心力衰竭或心肌梗死或ICD休克，结果：分为2组： A：n = 17，H / M MIBG比值？LVMD。两组的基线特征，心脏危险因素和药物治疗相当，A组中LVEF较低，RBBB较不常见。结论：在我们的初步研究中，我们没有发现添加基于SPECT的确定性价值LVMD可预测SHF患者心脏MIBG异常影像。尽管我们的样本量太小，无法得出任何明确的结论，但LVMD可能通过SHF进展中的不同途径独立发挥作用，因此不一定会为使用MIBG的AMSI测定增加增量价值。

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