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European Heart Journal Advance Access originally published online on March 17, 2008
European Heart Journal 2008 29(9):1147-1159; doi:10.1093/eurheartj/ehn113
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: a systematic review

Hein J. Verberne1,*, Lizzy M. Brewster2, G. Aernout Somsen3 and Berthe L.F. van Eck-Smit1

1 Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, F2-238, PO Box 22700, 1100 DE Amsterdam, The Netherlands
2 Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
3 Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

Received 19 September 2007; revised 15 January 2008; accepted 21 February 2008; online publish-ahead-of-print 17 March 2008.

* Corresponding author. Tel: +31 20 5669111, fax: +31 20 5669092, Email: h.j.verberne{at}amc.uva.nl

Aims: To derive a more precise estimate of the prognostic significance of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters [early heart mediastinal ratio (H/M), late H/M, and myocardial washout] in heart failure (HF).

Methods and results: Eighteen studies with a total of 1755 patients, stratifying survival, and cardiac events in patients with HF by MIBG, were eligible for analysis. The pooled hazard ratio (HR) estimates for cardiac death and cardiac events associated with washout showed no significant heterogeneity and were 1.72 [95%CI (confidence interval), 1.72–2.52; P = 0.006] and 1.08 (95%CI: 1.03–1.12; P < 0.001), respectively. The pooled HR estimates for cardiac death and cardiac events associated with early H/M and late H/M showed significant heterogeneity (I2 ≥ 75%). Limiting the pooling to the qualitative best three studies rendered I2 insignificant (I2 = 0) and resulted in a pooled HR of late H/M for cardiac death of 1.82 (95%CI: 0.80–4.12; P = 0.15) and for cardiac events of 1.98 (95%CI: 1.57–2.50; P < 0.001).

Conclusion: Our results indicate that patients with HF and decreased late H/M or increased myocardial MIBG washout have a worse prognosis compared with those with normal semi-quantitative myocardial MIBG parameters.

Key Words: Heart failure • Meta-analysis • Prognosis • MIBG


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