Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement

Abstract Aims In patients with aortic valve stenosis (AS), cardiac sympathetic nervous (CSN) dysfunction and its improvement after transcatheter aortic valve replacement (TAVR) have been reported. The prognostic impact of CSN function remains unclear. This study investigated the prognostic value of...

Full description

Bibliographic Details
Main Authors: Yoshito Kadoya, Kan Zen, Nagara Tamaki, Masaki Yashige, Kazuaki Takamatsu, Nobuyasu Ito, Kensuke Kuwabara, Michiyo Yamano, Tetsuhiro Yamano, Takeshi Nakamura, Hitoshi Yaku, Satoaki Matoba
Format: Article
Language:English
Published: Wiley 2021-04-01
Series:ESC Heart Failure
Subjects:
Online Access:https://doi.org/10.1002/ehf2.13123
id doaj-4c6a8d61cf4c4e5ab9f44207d9468489
record_format Article
collection DOAJ
language English
format Article
sources DOAJ
author Yoshito Kadoya
Kan Zen
Nagara Tamaki
Masaki Yashige
Kazuaki Takamatsu
Nobuyasu Ito
Kensuke Kuwabara
Michiyo Yamano
Tetsuhiro Yamano
Takeshi Nakamura
Hitoshi Yaku
Satoaki Matoba
spellingShingle Yoshito Kadoya
Kan Zen
Nagara Tamaki
Masaki Yashige
Kazuaki Takamatsu
Nobuyasu Ito
Kensuke Kuwabara
Michiyo Yamano
Tetsuhiro Yamano
Takeshi Nakamura
Hitoshi Yaku
Satoaki Matoba
Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
ESC Heart Failure
Cardiac 123I‐metaiodobenzylguanidine imaging
Aortic valve stenosis
Transcatheter aortic valve replacement
Heart–mediastinum ratio
Outcomes
author_facet Yoshito Kadoya
Kan Zen
Nagara Tamaki
Masaki Yashige
Kazuaki Takamatsu
Nobuyasu Ito
Kensuke Kuwabara
Michiyo Yamano
Tetsuhiro Yamano
Takeshi Nakamura
Hitoshi Yaku
Satoaki Matoba
author_sort Yoshito Kadoya
title Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
title_short Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
title_full Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
title_fullStr Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
title_full_unstemmed Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
title_sort prognostic value of cardiac 123i‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
publisher Wiley
series ESC Heart Failure
issn 2055-5822
publishDate 2021-04-01
description Abstract Aims In patients with aortic valve stenosis (AS), cardiac sympathetic nervous (CSN) dysfunction and its improvement after transcatheter aortic valve replacement (TAVR) have been reported. The prognostic impact of CSN function remains unclear. This study investigated the prognostic value of cardiac 123I‐metaiodobenzylguanidine (MIBG) imaging for predicting cardiac events after TAVR. Methods and results This single‐centre prospective observational study enrolled patients with AS between July 2017 and May 2019. MIBG scintigraphy was performed before and soon after TAVR to evaluate the late heart–mediastinum ratio (L‐H/M). Patients were classified into three pairs of groups based on the baseline and post‐TAVR L‐H/M (≥2.0 or <2.0) and on the presence of TAVR‐related improvement in L‐H/M. The study endpoint was the occurrence of major adverse cardiac events (MACE), defined as a composite of all‐cause death, non‐fatal myocardial infarction, and hospitalization due to heart failure. Among the 187 consecutive patients who underwent TAVR, 107 (27 men; median age: 86 years) were evaluated. Over a median follow‐up of 366 days, 15 (14.0%) patients had MACE. The incidence of MACE was significantly low in patients with L‐H/M improvement and/or high post‐TAVR L‐H/M (≥2.0). Baseline L‐H/M and frailty were associated with poor response of L‐H/M to TAVR treatment. TAVR‐related improvement in L‐H/M had significant effects on MACE, with an adjusted hazard ratio of 0.233 (95% confidence interval, 0.064–0.856; P = 0.028). Conclusions TAVR‐related improvement in L‐H/M was an independent predictor of cardiac events, 1 year after TAVR. Cardiac MIBG imaging is useful for predicting cardiac events after TAVR.
topic Cardiac 123I‐metaiodobenzylguanidine imaging
Aortic valve stenosis
Transcatheter aortic valve replacement
Heart–mediastinum ratio
Outcomes
url https://doi.org/10.1002/ehf2.13123
work_keys_str_mv AT yoshitokadoya prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT kanzen prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT nagaratamaki prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT masakiyashige prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT kazuakitakamatsu prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT nobuyasuito prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT kensukekuwabara prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT michiyoyamano prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT tetsuhiroyamano prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT takeshinakamura prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT hitoshiyaku prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
AT satoakimatoba prognosticvalueofcardiac123imetaiodobenzylguanidineimagingforpredictingcardiaceventsaftertranscatheteraorticvalvereplacement
_version_ 1724198512071016448
spelling doaj-4c6a8d61cf4c4e5ab9f44207d94684892021-03-29T13:28:35ZengWileyESC Heart Failure2055-58222021-04-01821106111610.1002/ehf2.13123Prognostic value of cardiac 123I‐metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacementYoshito Kadoya0Kan Zen1Nagara Tamaki2Masaki Yashige3Kazuaki Takamatsu4Nobuyasu Ito5Kensuke Kuwabara6Michiyo Yamano7Tetsuhiro Yamano8Takeshi Nakamura9Hitoshi Yaku10Satoaki Matoba11Department of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Radiology Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Surgery Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanDepartment of Cardiovascular Medicine Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465 Kajii‐cho, Kawaramachi‐Hirokoji, Kamigyo‐ku Kyoto 602‐8566 JapanAbstract Aims In patients with aortic valve stenosis (AS), cardiac sympathetic nervous (CSN) dysfunction and its improvement after transcatheter aortic valve replacement (TAVR) have been reported. The prognostic impact of CSN function remains unclear. This study investigated the prognostic value of cardiac 123I‐metaiodobenzylguanidine (MIBG) imaging for predicting cardiac events after TAVR. Methods and results This single‐centre prospective observational study enrolled patients with AS between July 2017 and May 2019. MIBG scintigraphy was performed before and soon after TAVR to evaluate the late heart–mediastinum ratio (L‐H/M). Patients were classified into three pairs of groups based on the baseline and post‐TAVR L‐H/M (≥2.0 or <2.0) and on the presence of TAVR‐related improvement in L‐H/M. The study endpoint was the occurrence of major adverse cardiac events (MACE), defined as a composite of all‐cause death, non‐fatal myocardial infarction, and hospitalization due to heart failure. Among the 187 consecutive patients who underwent TAVR, 107 (27 men; median age: 86 years) were evaluated. Over a median follow‐up of 366 days, 15 (14.0%) patients had MACE. The incidence of MACE was significantly low in patients with L‐H/M improvement and/or high post‐TAVR L‐H/M (≥2.0). Baseline L‐H/M and frailty were associated with poor response of L‐H/M to TAVR treatment. TAVR‐related improvement in L‐H/M had significant effects on MACE, with an adjusted hazard ratio of 0.233 (95% confidence interval, 0.064–0.856; P = 0.028). Conclusions TAVR‐related improvement in L‐H/M was an independent predictor of cardiac events, 1 year after TAVR. Cardiac MIBG imaging is useful for predicting cardiac events after TAVR.https://doi.org/10.1002/ehf2.13123Cardiac 123I‐metaiodobenzylguanidine imagingAortic valve stenosisTranscatheter aortic valve replacementHeart–mediastinum ratioOutcomes