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J Am Coll Cardiol, 2003; 41:231-238
© 2003 by the American College of Cardiology Foundation
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Comparison of the prognostic value of cardiac iodine-123 metaiodobenzylguanidine imaging and heart rate variability in patients with chronic heart failure

A prospective study

Takahisa Yamada, MD*,*, Tsuyoshi Shimonagata, MD*, Masatake Fukunami, MD*, Kazuaki Kumagai, MD*, Hisakazu Ogita, MD{dagger}, Akio Hirata, MD*, Mitsutoshi Asai, MD*, Nobuhiko Makino, MD*, Hidetaka Kioka, MD*, Hideo Kusuoka, MD{ddagger}, Masatsugu Hori, MD{dagger} and Noritake Hoki, MD*

* Division of Cardiology, Osaka Prefectural General Hospital, Osaka, Japan
{dagger} Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan
{ddagger} Institute for Clinical Research, Osaka National Hospital, Osaka, Japan



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Figure 1 Iodine-123 metaiodobenzylguanidine (MIBG) imaging in a patient with chronic heart failure (HF). Heart (H) and mediastinum (M) were selected, as shown, to measure the H/M ratio. The cardiac MIBG washout rate (WR) was calculated from the initial (left) and delayed images (right).

 


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Figure 2 Plots of data of cardiac metaiodobenzylguanidine (MIBG) imaging in patients with chronic heart failure with and without cardiac events. H/M(e) and H/M(d) denote the cardiac MIBG heart to mediastinum ratio (H/M) on the early and delayed images, respectively. Patients with cardiac events had a significantly lower H/M(d) and higher washout rate (WR) than did those without cardiac events, although there was no significant difference in H/M(e) between the two groups.

 


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Figure 3 The cardiac event-free rate curves by Kaplan-Meier analysis in patients with chronic heart failure with and without an abnormal washout rate (WR) (>27%). The cardiac event-free rate was significantly lower in patients with an abnormal WR than in those without it.

 


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Figure 4 The cardiac event-free rate curves by Kaplan-Meier analysis in patients with chronic heart failure with and without abnormal normalized very-low-frequency power (n-VLFP) (<22). The cardiac event-free rate was significantly lower in patients with abnormal n-VLFP than in those without it.

 


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Figure 5 The cardiac event-free rate curves by Kaplan-Meier analysis in patients with chronic heart failure, according to a combination of abnormal washout rate (WR) and normalized very-low-frequency power (n-VLFP). The cardiac event-free rate was significantly lower in patients with both an abnormal WR and n-VLFP than in those with both a normal WR and n-VLFP.

 




 
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