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...
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Wiley
2021-04-01
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Series: | ESC Heart Failure |
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Online Access: | https://doi.org/10.1002/ehf2.13123 |
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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 |
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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 |