Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony

Background. Left ventricular mechanical dyssynchrony (LVMD), left ventricular hypertrophy, and impaired cardiac sympathetic innervation are closely related to the development of heart failure (HF) and unfavorable outcomes. Methods and Results. A total of 705 consecutive HF patients with reduced left...

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Autores principales:	Takahiro Doi, Tomoaki Nakata, Takahiro Noto, Tomohiro Mita, Daigo Nagahara, Satoshi Yuda, Akiyoshi Hashimoto
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	heart failure cardiac sympathetic function prognosis mechanical left ventricular dyssynchrony Medicine R
Acceso en línea:	https://doaj.org/article/b2a844d94eda44579fcc147be549d190
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spelling	oai:doaj.org-article:b2a844d94eda44579fcc147be549d1902021-11-11T17:40:00ZImpaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony10.3390/jcm102150472077-0383https://doaj.org/article/b2a844d94eda44579fcc147be549d1902021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5047https://doaj.org/toc/2077-0383Background. Left ventricular mechanical dyssynchrony (LVMD), left ventricular hypertrophy, and impaired cardiac sympathetic innervation are closely related to the development of heart failure (HF) and unfavorable outcomes. Methods and Results. A total of 705 consecutive HF patients with reduced left ventricular ejection fraction (EF) < 50% were registered in our hospital HF database. LVMD and left ventricular mass index (LVMI) were evaluated three-dimensionally by gated myocardial perfusion SPECT. LVMD was measured as a heterogeneity index (phase SD) of the regional contraction phase angles calculated by Fourier analysis. Cardiac sympathetic innervation was quantified as a normalized heart-to-mediastinum ratio (HMR) of the <sup>123</sup>I-metaiodobenzylguanidine (MIBG) activity. The patients were followed up with a primary end point of lethal cardiac events (CEs) for 42 months. CEs were documented in 246 of the HF patients who had a greater phase SD, greater LVMI, and lower MIBG HMR than those in HF patients without CEs. In the overall multivariate analysis, phase SD, LVMI, and MIBG HMR were identified as significant CE determinants. The three biomarkers were incrementally related to increases in CE risks. Conclusions. Assessment of cardiac sympathetic innervation can further stratify patients with systolic heart failure at increased cardiac risk identified by left ventricular hypertrophy and mechanical dyssynchrony.Takahiro DoiTomoaki NakataTakahiro NotoTomohiro MitaDaigo NagaharaSatoshi YudaAkiyoshi HashimotoMDPI AGarticleheart failurecardiac sympathetic functionprognosismechanical left ventricular dyssynchronyMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5047, p 5047 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	heart failure cardiac sympathetic function prognosis mechanical left ventricular dyssynchrony Medicine R
spellingShingle	heart failure cardiac sympathetic function prognosis mechanical left ventricular dyssynchrony Medicine R Takahiro Doi Tomoaki Nakata Takahiro Noto Tomohiro Mita Daigo Nagahara Satoshi Yuda Akiyoshi Hashimoto Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony
description	Background. Left ventricular mechanical dyssynchrony (LVMD), left ventricular hypertrophy, and impaired cardiac sympathetic innervation are closely related to the development of heart failure (HF) and unfavorable outcomes. Methods and Results. A total of 705 consecutive HF patients with reduced left ventricular ejection fraction (EF) < 50% were registered in our hospital HF database. LVMD and left ventricular mass index (LVMI) were evaluated three-dimensionally by gated myocardial perfusion SPECT. LVMD was measured as a heterogeneity index (phase SD) of the regional contraction phase angles calculated by Fourier analysis. Cardiac sympathetic innervation was quantified as a normalized heart-to-mediastinum ratio (HMR) of the <sup>123</sup>I-metaiodobenzylguanidine (MIBG) activity. The patients were followed up with a primary end point of lethal cardiac events (CEs) for 42 months. CEs were documented in 246 of the HF patients who had a greater phase SD, greater LVMI, and lower MIBG HMR than those in HF patients without CEs. In the overall multivariate analysis, phase SD, LVMI, and MIBG HMR were identified as significant CE determinants. The three biomarkers were incrementally related to increases in CE risks. Conclusions. Assessment of cardiac sympathetic innervation can further stratify patients with systolic heart failure at increased cardiac risk identified by left ventricular hypertrophy and mechanical dyssynchrony.
format	article
author	Takahiro Doi Tomoaki Nakata Takahiro Noto Tomohiro Mita Daigo Nagahara Satoshi Yuda Akiyoshi Hashimoto
author_facet	Takahiro Doi Tomoaki Nakata Takahiro Noto Tomohiro Mita Daigo Nagahara Satoshi Yuda Akiyoshi Hashimoto
author_sort	Takahiro Doi
title	Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony
title_short	Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony
title_full	Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony
title_fullStr	Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony
title_full_unstemmed	Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony
title_sort	impaired cardiac sympathetic innervation increases the risk of cardiac events in heart failure patients with left ventricular hypertrophy and mechanical dyssynchrony
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b2a844d94eda44579fcc147be549d190
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Impaired Cardiac Sympathetic Innervation Increases the Risk of Cardiac Events in Heart Failure Patients with Left Ventricular Hypertrophy and Mechanical Dyssynchrony

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