Clinical Value of Cardiac Neurotransmission SPECT Imaging in Heart Failure Patients

Author(s): Denis Agostini, Damien Legallois and Alain Manrique

Pp: 335-350 (16)

* (Excluding Mailing and Handling)

Abstract

In patients with ischemic or non-ischemic cardiomyopathy and left ventricular ejection fraction <35%, 123I-metaiodobenzylguanidine (MIBG) imaging can contribute to risk stratification, identifying those patients who are at high risk of sudden cardiac death. This chapter reviews in the first part: recent publications concerning the interest of 123I-MIBG scintigraphy to stratify patients suffering from heart failure and / or ventricular tachyarrhythmia. Then, in a second part, we selected among different therapeutic devices (implantable cardioverter-defibrillator – cardiac resynchronization therapy) some publications about the effects of left ventricular assistance device on the neuronal function of the heart in patients with severe cardiac impairment. Finally, the interpretation of different parameters, such as Heart-Mediastinum Ratio (HMR) or myocardial SPECT scores as regional LV dysinnervation using 123I-MIBG scintigraphy, need some recommendations from the European and Japanese Cardio-Vascular committees.

Keywords: Cardiac autonomous nervous system, Dilated cardiomyopathy, Heart failure, Heart – mediastinum rate, Ischemic cardiomyopathy, Left ventricular assistance device, MIBG, Scintigraphy, Ventricular tachyarrhythmia, Washout ratio.