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Inicio arrow Cardiología - XXIII Congreso de ALASBIMN: Resúmene arrow 123I-MIBG cardiac imaging to evaluate beta-blocker therapy in heart failure

Alasbimn Journal Year 14, Number 54, October 2011 / Año 14, Nº 54, Octubre 2011
XXIII Congreso de ALASBIMN: Resúmenes.

123I-MIBG cardiac imaging to evaluate beta-blocker therapy in heart failure. 

 

Trabalho No. 253.
Apresentação Pôster Especial.
Autor Apresentador: Sandra Marina Miranda.
Outros Autores: Jader C Azevedo, Renta Felix, Livia M Guimarães, Laiz B. Barachi, Leandro Messias, Pedro Gemal, Evandro T Mesquita, Claudio Tinoco Mesquita.
Instituição: Hospital Pró-Cardíaco e Universidade Federal Fluminense.
País: Brasil

 

Background

Sympathetic nervous system hyperactivity is one of the abnormalities found in heart failure and is associated with increased morbidity and mortality. The cardiac imaging with 123I-metaiodobenzylguanidine (MIBG) is a method able to study sympathetic activity and it’s response to beta-blocker therapy.

Objective

To assess the cardiac adrenergic neurotransmission with 123I-MIBG in the short and medium term after beta-blocker therapy.

Methods

Heart failure patients without beta-blocker therapy (n=28), 18 men, mean age 55.04 ± 11.87 years and ejection fraction (EF) of 27.2 ± 8.1% performed 123I-MIBG cardiac imaging before, 3 months (n = 24) and 12 months (n = 13) throughout therapy. Serum catecholamines and Radionuclide ventriculography was done before and after treatment. The adrenergic cardiac and sympathetic activity were quantified by 123I-MIBG (normal = washout ≤ 27% and heart/mediastinum ratio - He/Me > 1.8 both in 30 minutes and 4 hours). P value was <0.05.

Results

Functional class improved in 75% of patients at 3 months and in 100% of patients that concluded 12 months follow-up (n=13). Mean EF was 28%±10, 32%±12 and 44%±12 at baseline, 3 and 12 months respectively (p<0.05). The 30 minutes and 4 hours He/Me ratio improved from 1.61±0.19 and 1.53±0.17 at baseline to 1.92±0.19 and 1.91±0.18 at 12months (p<0,05), not improved at 3 months. Washout showed improvement at 12 months follow-up (32% at baseline, 34% at 3 months and 27% at 12 months; p<0,05).

Conclusion

Improvement of functional class and ejection fraction was noted from the 3rd month on beta-blocker therapy. However the cardiac adrenergic neurotransmission and sympathetic tone improvement were noted only after the 12th month on treatment. These data suggest that systolic function determines the innervation recovery after beta-blocker therapy inititation.  

 
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