Cardiac Iodine-123 metaiodobenzylguanidine imaging predicts sudden cardiac death independently of left ventricular ejection fraction in patients with chronic heart failure and left ventricular systolic dysfunction  

Cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging has recently received a lot of renewed attention for risk stratification of patients with heart failure.  In this study Tamaki et al (1) studied 106 patients with stable heart failure (LVEF < 40%) with both MIBG imaging and electrocardiographic risk markers for sudden death (including SAECG, heart rate variability and QT dispersion). After a long-term follow-up of 65 months, cardiac MIBG but not electrocardiographic parameters appeared as a powerful independent risk factor for sudden death.  The small sample size hampers definite conclusions on the usefulness of cardiac MIBG imaging, but the results are promising in view of ongoing large scale clinical trials of MIBG imaging in heart failure and ICD patients.

1. Tamaki S, Yamada T, Okuyama Y et al. Cardiac Iodine-123 metaiodobenzylguanidine imaging predicts sudden cardiac death independently of left ventricular ejection fraction in patients with chronic heart failure and left ventricular systolic dysfunction   J Am Coll Cardiol 2009;53:426-435.