REVIEW OF THE VALUE OF I-123 METAIODOBENZ YLGUANIDINE CARDIAC SCINTIGRAPHY IN CONGESTED HEART-FAILURE

Heart failure is accompanied by major disturbances of the functioning of the sympathetic nervous system: global overactivation and local mod ifications of the adrenergic system. I-123-MIBG cardiac scintigraphy i s an isotope technique investigating presynaptic adrenergic function. The cardiac uptake of MIBG is decreased during heart failure, reflecti ng a reduction of norepinephrine reuptake by cardiac presynaptic nerve endings. Alteration of presynaptic finction occurs early and plays an important role in the pathogenesis of the deterioration of heart fail ure. I-123-MIBG cardiac scintigraphy allows in vivo assessment of the myocardial adrenergic reserves of patients with congestive heart failu re. It should be proposed in all patients with severe ventricular dysf unction to help define the indications for heart transplantation.