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Cardiac sympathetic nerve abnormality predicts ventricular tachyarrhythmic events in patients without conventional risk of sudden death
- Source :
- European Journal of Nuclear Medicine and Molecular Imaging. 35:2066-2073
- Publication Year :
- 2008
- Publisher :
- Springer Science and Business Media LLC, 2008.
-
Abstract
- Patients with structural heart disease, severe left ventricular dysfunction, or history of cardiac arrest are at increased risk of sudden cardiac death. However, a useful marker for predicting sudden cardiac death is not clarified in low-risk patients without those conventional risks. We hypothesized that cardiac sympathetic nerve system (SNS) abnormality would be associated with ventricular tachyarrhythmic events in low-risk patients with ventricular tachycardia (VT).Iodine-123 metaiodobenzylguanidine ((123)I-MIBG) scintigraphy was performed in 50 patients (mean+/-standard deviation, age 54 +/- 16 years, 52% males) with VT who did not have structural heart disease, severe left ventricular dysfunction, or history of cardiac arrest, and SNS activity was assessed from heart/mediastinal (H/M) ratio on delayed images.Over 11 years of follow-up, three patients had sudden deaths (6%) and nine patients had sustained ventricular tachyarrhythmic events (18%). SNS abnormality, defined as H/M ratio2.8, was predictive of sudden death or ventricular tachyarrhythmic events (45% in nine of 20 patients with SNS abnormality vs 16.7% in three of 30 patients without SNS abnormality, p = 0.005). After adjustment for potential confounding variables including slight left ventricular dysfunction, SNS abnormality remained independently predictive of ventricular tachyarrhythmic events with a hazard ratio of 5.3 (95% confidence interval = 1.4 to 20.8, p = 0.016).SNS abnormality is a readily available and powerful predictor of recurrent ventricular tachyarrhythmic events in patients with VT who did not have conventional risk of sudden cardiac death. (123)I-MIBG scintigraphy can provide prognostic information of VT patients without conventional risk.
- Subjects :
- Adult
Male
Risk
medicine.medical_specialty
Sympathetic Nervous System
Time Factors
Heart disease
Scintigraphy
Ventricular tachycardia
Sudden death
Sudden cardiac death
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
Radionuclide Imaging
medicine.diagnostic_test
business.industry
Hazard ratio
Confounding
Heart
General Medicine
Prognosis
medicine.disease
3-Iodobenzylguanidine
Death, Sudden, Cardiac
Tachycardia, Ventricular
cardiovascular system
Cardiology
Female
Abnormality
business
Subjects
Details
- ISSN :
- 16197089 and 16197070
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- European Journal of Nuclear Medicine and Molecular Imaging
- Accession number :
- edsair.doi.dedup.....0cd8abe9b68d31452041d46a2f363e5d