Bax, Jeroen J.;
Kraft, Otakar;
Buxton, Alfred E.;
Fjeld, Jan Gunnar;
Pařízek, Petr;
Agostini, Denis;
Knuuti, Juhani;
Flotats, Albert;
Arrighi, James;
Muxi, Africa;
Alibelli, Marie-Jeanne;
Banerjee, Gopa;
Jacobson, Arnold F.
123 I- m IBG Scintigraphy to Predict Inducibility of Ventricular Arrhythmias on Cardiac Electrophysiology Testing : A Prospective Multicenter Pilot Study
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Medientyp:
E-Artikel
Titel:
123 I- m IBG Scintigraphy to Predict Inducibility of Ventricular Arrhythmias on Cardiac Electrophysiology Testing : A Prospective Multicenter Pilot Study
:
A Prospective Multicenter Pilot Study
Beteiligte:
Bax, Jeroen J.;
Kraft, Otakar;
Buxton, Alfred E.;
Fjeld, Jan Gunnar;
Pařízek, Petr;
Agostini, Denis;
Knuuti, Juhani;
Flotats, Albert;
Arrighi, James;
Muxi, Africa;
Alibelli, Marie-Jeanne;
Banerjee, Gopa;
Jacobson, Arnold F.
Erschienen in:
Circulation: Cardiovascular Imaging, 1 (2008) 2, Seite 131-140
Sprache:
Englisch
DOI:
10.1161/circimaging.108.782433
ISSN:
1941-9651;
1942-0080
Entstehung:
Anmerkungen:
Beschreibung:
<jats:p>
<jats:bold>
<jats:italic>Background—</jats:italic>
</jats:bold>
Disturbances of autonomic function after infarction are associated with both total mortality and sudden death. Although many imaging techniques for assessing the cardiac autonomic nervous system have been studied, the clinical usefulness of these techniques remains uncertain. This exploratory pilot study examined the relationship between abnormalities of ventricular sympathetic innervation delineated by scintigraphic imaging with
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG and inducible ventricular tachyarrhythmias in patients with left ventricular dysfunction and previous myocardial infarction.
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Methods and Results—</jats:italic>
</jats:bold>
Fifty patients underwent electrophysiological (EP) testing and 15-minute and 4-hour planar and single photon emission computed tomography (SPECT) imaging with
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG and SPECT imaging with
<jats:sup>99m</jats:sup>
Tc-tetrofosmin. The primary efficacy variables were the 4-hour heart:mediastinum ratio (H/M) and the
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG/
<jats:sup>99m</jats:sup>
Tc-tetrofosmin SPECT mismatch score. EP studies were categorized as positive (EP
<jats:sup>+</jats:sup>
) or negative (EP
<jats:sup>−</jats:sup>
) for inducibility of sustained (>30 seconds) ventricular tachyarrhythmias. Thirty patients were EP
<jats:sup>+</jats:sup>
, and 20 were EP
<jats:sup>−</jats:sup>
. There were no significant differences in the 4-hour H/M ratios or
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG/
<jats:sup>99m</jats:sup>
Tc-tetrofosmin SPECT mismatch scores between the two groups. In a multivariable analysis using all
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG and
<jats:sup>99m</jats:sup>
Tc-tetrofosmin SPECT measurements, the only variable that showed a significant difference between EP
<jats:sup>+</jats:sup>
and EP
<jats:sup>−</jats:sup>
patients was the 4-hour
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG SPECT defect score. A 4-hour
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG SPECT defect score of ≥37 yielded a sensitivity of 77% and specificity of 75% for predicting EP results.
</jats:p>
<jats:p>
<jats:bold>
<jats:italic>Conclusions—</jats:italic>
</jats:bold>
The standard indices of
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG imaging (H/M and innervation-perfusion mismatch score) are not predictive of EP test results. The association of
<jats:sup>123</jats:sup>
I-
<jats:italic>m</jats:italic>
IBG SPECT defect severity with EP test inducibility in this exploratory study will require confirmation in a larger cohort of patients.
</jats:p>