Prognostic significance of cardiac I-123 metaiodobenzylguanidine imaging for mortality and morbidity in patients failure: a prospective with chronic heart study

Objective-To determine whether cardiac iodine-123 metaiodobenzylguanidine ( I-123 MIBG) imaging is useful in predicting the prognosis of patients with chronic heart failure. Design-Cardiac I-123 MIBG imaging was done on entry to the study. The cardi ac MIBG washout rate was calculated from anterior chest view images obtaine d 20 and 200 minutes after injection of the isotope. Study patients were di vided into two groups with washout rates above and below 27% (the mean valu e + 2 SD obtained in 20 normal subjects), and were then followed up. Setting-Tertiary referral centre. Patients-79 patients with chronic heart failure in whom the left ventricula r ejection fraction was less than 40%. Results-There were 37 patients in group 1 (washout rate of greater than or equal to 27%) and 42 in group 2 (< 27%). During a follow up period of betwe en 1 and 52 months, eight patients died suddenly and five died of worsening heart failure in group 1, while none died in group 2; 13 patients in group 1 and four in group 2 were admitted to hospital for progressive heart fail ure. Kaplan-Meier analysis showed that group 1 had a significantly higher m ortality and morbidity (p = 0.001 and p < 0.001, respectively) than group 2 . Conclusions-Cardiac I-123 MIBG washout rate seems to be a good predictor of prognosis in patients with chronic heart failure.