Abstract
The autonomic nervous system interacts in the pathophysiology of heart failure. Dysfunction of the sympathetic nervous system has been identified as an important prognostic marker in patients with chronic heart failure. At present, cardiac sympathetic nerve imaging with 123-iodine metaiodobenzylguanidine [123-I MIBG] has been employed most frequently for the assessment of cardiac sympathetic innervation and activation pattern. The majority of studies have shown that cardiac sympathetic dysfunction as assessed with 123-I MIBG imaging is a powerful predictor for heart failure mortality and morbidity. Additionally, 123-I MIBG imaging can be used for prediction of potentially lethal ventricular tachyarrhythmias in heart failure patients. At present however, the lack of standardization of 123-I MIBG imaging procedures represents an evident issue. Standardized criteria on the use of 123-I MIBG imaging will further strengthen the clinical use of 123-I MIBG imaging in heart failure patients.
Highlights
Chronic heart failure represents one of the most important challenges in clinical cardiology since several decades [1, 2]
The authors have postulated that 123-I MIBG imaging can be used for the identification of patients at risk for potentially lethal ventricular tachyarrhythmias. Another important study was performed by Tamaki et al [22] who evaluated whether 123-I MIBG imaging could be valuable for prediction of sudden arrhythmic death in 106 consecutive patients diagnosed with chronic heart failure
123-I MIBG imaging has been used for the assessment of abnormalities in cardiac sympathetic innervation and activation
Summary
Chronic heart failure represents one of the most important challenges in clinical cardiology since several decades [1, 2]. Different studies have sought to quantify global and regional abnormalities in sympathetic innervation in patients with heart failure using PET imaging [8,9,10]. A large number of studies have sought to determine the prognostic value of sympathetic nerve imaging with 123-I MIBG in patients diagnosed with chronic heart failure [11,12,13,14,15, 18].
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