Do myocardial 123I-MIBG parameters predict cardiac death and cardiac events in patients with heart failure?
Decreased late H/M or increased myocardial MIBG washout on 123I-MIBG imaging is associated with a worse prognosis in patients with heart failure.
AIMS: To derive a more precise estimate of the prognostic significance of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters early heart mediastinal ratio (H/M), late H/M, and myocardial washout in heart failure (HF). METHODS AND RESULTS: Eighteen studies with a total of 1755 patients, stratifying survival, and cardiac events in patients with HF by MIBG, were eligible for analysis. The pooled hazard ratio (HR) estimates for cardiac death and cardiac events associated with washout showed no significant heterogeneity and were 1.72 95%CI (confidence interval), 1.72-2.52; P = 0.006 and 1.08 (95%CI: 1.03-1.12; P or = 75%). Limiting the pooling to the qualitative best three studies rendered I2 insignificant (I2 = 0) and resulted in a pooled HR of late H/M for cardiac death of 1.82 (95%CI: 0.80-4.12; P = 0.15) and for cardiac events of 1.98 (95%CI: 1.57-2.50; P < 0.001). CONCLUSION: Our results indicate that patients with HF and decreased late H/M or increased myocardial MIBG washout have a worse prognosis compared with those with normal semi-quantitative myocardial MIBG parameters.
Verberne et al. (Mon,) studied this question.