Abstract 20910: Relationship Between Left Ventricular Diastolic Function and Cardiac Sympathetic Nerve Activity in Heart Failure Patients With Reduced and Preserved Ejection Fraction
Introduction: Cardiac sympathetic nerve activity (CSNA) by Iodine-123 meta-iodobenzylguanidine (MIBG) is evaluated with delayed heart-to-mediastinum ratio (H/M). Delayed H/M less than 1.6 indicates higher risk of cardiac adverse events. Although left ventricular (LV) ejection fraction (EF) has been known to be associated with CSNA, it remains unknown how LV diastolic function is associated with CSNA in HF patients.
Hypothesis: LV diastolic function was associated with cardiac sympathetic nerve activity in both HF patients with reduced and preserved EF (HFrEF and HFpEF).
Methods: We retrospectively studied 384 consecutive patients (age 68±15 years, 124 females, EF 42±16%) admitted to our hospital for HF. LV diastolic function was assessed by the ratio of transmitral peak E-wave velocity to peak A-wave velocity (E/A), the deceleration time of E-wave (DT) and the ratio of transmitral peak E-wave velocity to mitral annular diastolic velocity (E/e’), and LV systolic function was assessed by EF using echocardiography. Cardiac Sympathetic Nerve Activity was assessed by H/M using MIBG.
Results: In all 384 patients, EF, E/A, DT, and E/e’ significantly correlated with H/M (all p<0.0001). In HFrEF (n=261, EF33±10%), these parameters significantly correlated with H/M (all p<0.01). In HFpEF (n=123, EF61±8%), E/A, DT, E/e’ significantly correlated with H/M (all p<0.05), but EF did not. Multivariate analysis showed LV diastolic parameters were independent predictors for cardiac sympathetic nerve activity in all patients, HFrEF, and HFpEF. ROC curve analyses revealed E/A, DT, and E/e’ were excellent predictors of H/M<1.6 (AUC 0.621, 0.631, and 0.603; respectively; all p<0.01).
Conclusions: LV diastolic function was strongly associated with cardiac sympathetic nerve activity in HF patients regardless of EF. Especially, in HFpEF, cardiac sympathetic nerve activity was significantly associated with LV diastolic function, but not EF.
Author Disclosures: T. Onishi: None. H. Kawai: None. H. Tanaka: None. K. Hirata: None.
- © 2016 by American Heart Association, Inc.