Abstract 9794: Preoperative Iodine-123 MIBG Scintigraphy Imaging as an Excellent Predictor of Left Ventricular Reverse Remodeling During Ventricular Assist Device Therapy
Introduction: Although left ventricular reverse remodeling (LVRR) is accompanied by better clinical course during ventricular assist device (VAD) treatment, its preoperative prediction remains uncertain. 123I-metaiodobenzylguanidine (123I-MIBG) is a recently-developed analog of guanethidine, used either to stratify heart failure (HF) or to predict HF patient prognosis by assessing visualized cardiac sympathetic innervation.
Hypothesis: Preoperative 123I-MIBG may be useful to predict LVRR during VAD support.
Methods: We enrolled 27 HF patients due to dilated cardiomyopathy, who had received 123I-MIBG scintigraphy before the implantation of VAD and been followed at our institute at 2010-14. We investigated whether preoperative 123I-MIBG data were useful to predict postoperative LVRR defined as LV ejection fraction ≥35% at post-VAD 6 months.
Results: Among preoperative variables including 123I-MIBG data, washout rate (WR) ≤39% was an only significant independent predictor of postoperative LVRR by uni/multivariate logistic regression analyses (p=0.036 and odds ratio 14.45). Those with LVRR had better exercise capacity including higher peak oxygen consumption at cardiopulmonary exercise test and longer 6 minutes’ walk distances, and more frequent opening of native aortic valve accompanied by lower plasma level of B-type natriuretic peptide at post-VAD 6 months (p<0.05 for all), although their daily dose of β-blocker was comparable with those without LVRR during the study period. All 2 patients who achieved explantation of VAD had experienced LVRR.
Conclusions: Preoperative lower WR in 123I-MIBG was a novel predictor of LVRR during VAD support.
Author Disclosures: T. Imamura: None. K. Kinugawa: None. D. Nitta: None. M. Hatano: None. O. Kinoshita: None. K. Nawata: None. M. Ono: None.
- © 2015 by American Heart Association, Inc.