123Iodo-MIBG in the Study of Patients with Heart Failure and Severe Impairment of Ventricular Function Pages 13-19

M. Gomez1, L. Ortiz2, M. Maydana1, M. Uriarte1, A. Medina1, M. Mónaco3 and D. Echazarreta4

1Staff Nuclear Medicine Service Centro Médico Capital (CEMEC); 2Staff Echocardiography Service CEMEC; 3Nuclear Medicine Service Technician CEMEC; 4Nuclear Medicine ServiceCoordinator CEMEC, Av. 60 n•462 CP 1900, Buenos Aires, Argentina

DOI: https://doi.org/10.12970/2311-052X.2020.08.03

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Abstract: Increased cardiac sympathetic nerve activity is a prominent feature in the pathophysiology of heart failure (HF) that is associated with progressive left ventricular remodeling, impaired left ventricular function, and worsening of symptoms with progression of functional class. Furthermore, alterations in sympathetic myocardial innervation play an important role in the generation of ventricular arrhythmias and sudden cardiac death (SCD).A high proportion of deaths that occur in patients with HF, especially those with mild symptoms or not in an advanced functional class of the New York Heart Association (NYHA), occur suddenly and unexpectedly. Heart Failure with reduced ejection fraction is a very prevalent entity, which generates significant public health costs each year, extremely high morbidity for those who suffer it, and a large number of deaths, many of them suddenly. In these patients, SCD can be treated, when due to arrhythmic causes, with the implantation of an ICD.This review attempts to demonstrate that evaluation of myocardial sympathetic innervation using the 123I-MIBG scan has prognostic value for predicting cardiovascular events in subjects with heart failure and severe impairment of LVEF.

Keywords: Heart Failure, 123iodine-labeled meta-iodobenzylguanidine (MIBG), Sudden Death.
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