Prognostic value of Iodine-123-metaiodobenzylguanidine imaging and cardiacnatriuretic peptide levels in patients with left ventricular dysfunction resulting from cardiomyopathy

This study assessed the prognostic value of Iodine-123-metaiodobenzylguanid ine (MIBG) imaging and of the plasma level of cardiac natriuretic peptides in patients with left ventricular dysfunction resulting from cardiomyopathy . Predictors of cardiac death or hospitalization related to progressive hea rt failure were examined in 171 patients with chronic heart failure (96 pat ients with idiopathic cardiomyopathy and 75 patients with ischemic cardiomy opathy). All patients underwent MIBG imaging at rest and other hemodynamic studies. During a mean (+/-SD) follow-up period of 27+/-11 months, 11 patie nts died from heart failure and 16 required hospitalization. High MIBG wash out was an independent predictor of cardiac death (relative risk [RR]=1.158 , p<0.0001) whereas the plasma level of brain natriuretic peptide (BNP: rel ative risk [RR] = 1.005, p<0.0001) and high MIBG washout (relative risk [RR ] = 1.094, p<0.0001) were predictors of progressive heart failure (ie, comb ined cardiac death and hospitalization). Accelerated myocardial adrenergic nerve activity as assessed by MIBG imaging and the plasma levels of BNP are powerful predictors of the patient's prognosis.