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Cardiac Sympathetic Imaging With mIBG in Heart Failure

Ignasi Carrió, MD^_*,_*, Martin R. Cowie, MD, MSc, Junichi Yamazaki, MD, James Udelson, MD^||, Paolo G. Camici, MD^_*,

^_* Hospital Sant Pau, Barcelona, Spain
National Heart & Lung Institute, Imperial College, London, United Kingdom
Clinical Sciences Centre, Imperial College, London, United Kingdom
Toho University School of Medicine, Tokyo, Japan
^|| Tufts University School of Medicine, Boston, Massachusetts

^_* Reprint requests and correspondence: Dr. Ignasi Carrió, Hospital Sant Pau, Nuclear Medicine, Pare Claret 167, Barcelona 08025, Spain (Email: icarrio{at}santpau.cat).

Cardiac sympathetic imaging with meta-iodobenzylguanidine (mIBG) is a noninvasive tool to risk stratify patients with heart failure (HF). In patients with ischemic and nonischemic cardiomyopathy, cardiac mIBG activity is a very powerful predictor of survival. Cardiac sympathetic imaging can help in understanding how sympathetic overactivity exerts its deleterious actions, which may result in better therapy and outcome for patients with HF.

Key Words: mIBG • heart failure • cardiac sympathetic imaging • sudden death • prognosis

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   BNP = brain natriuretic peptide   EP = electrophysiology   HF = heart failure   HMR = heart-to-mediastinum ratio   LVEF = left ventricular ejection fraction   mIBG = meta-iodobenzylguanidine   MPI = myocardial perfusion imaging   NE = norepinephrine   NYHA = New York Heart Association   SPECT = single-photon emission computed tomography   WO = wash-out

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