Abstract 16441: Influence of Diabetes Mellitus on Prognostic Utility of Cardiac Iodine-123-Metaiodobenzylguanidine in Diastolic Heart Failure Patients
Background: Iodine-123-metaiodobenzylguanidine (123I-MIBG) has been used to assess function of the cardiac sympathetic nervous system in patients with chronic heart failure. Recently, we and others demonstrated that cardiac 123I-MIBG imaging represented a prognostic marker in not only systolic heart failure (SHF) patients and but also diastolic heart failure (DHF) patients. From sub-analysis of ADMIRE-HF trial, the group of SHF patients with diabetes mellitus (DM) who presented low heart to mediastinum (H/M) ratio showed poor prognosis in other groups. Epidemiologic and experimental study demonstrated that hyperglycemia facilitated myocardial diastolic dysfunction. Therefore, we examined the influence of DM on prognostic utility of cardiac 123I-MIBG imaging in DHF patients.
Methods and Results: We performed 123I-MIBG scintigraphy and echocardiography in consecutive 128 heart failure patients with left ventricular ejection fraction ≥ 50% (71 men, mean age 64±15 years) who admitted to our hospital. Patients were divided into 2 groups by the presence of DM. 123I-MIBG delayed H/M ratio was lower in DHF patients with DM than in those without DM (DM vs. non-DM: 1.60 ± 0.33 vs. 1.89 ± 0.36, p = 0.0002). Moreover, DHF patients with high 123I-MIBG H/M ratio and DM showed poor clinical outcome (p = 0.0377).
Conclusion: DHF patients with DM showed lower cardiac 123I-MIBG delayed H/M ratio than those without DM. Presence of DM adversely affect the prognostic capability of cardiac 123I-MIBG imaging results.
- © 2010 by American Heart Association, Inc.