Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure
Background 123Iodine‐meta‐iodobenzylguanidine scintigraphy is useful for assessing cardiac autonomic dysfunction and predict outcomes in heart failure (HF). The relationship of cardiac sympathetic function with myocardial remodeling and diffuse fibrosis remains largely unknown. We aimed to evaluate...
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Wiley
2024-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.035264 |
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| author | Luis M. da Silva Andréa Coy‐Canguçu Layde R. Paim Adriana A. Bau Camila Nicolela Geraldo Martins Stephan Pinheiro Vinicius Citeli Ribeiro Walter E. Magalhães Rocha Jose R. Mattos‐Souza Roberto Schreiber Lígia Antunes‐Correa Andrei Sposito Wilson Nadruz Celso D. Ramos Tomas Neilan Michael Jerosch‐Herold Otávio R. Coelho‐Filho |
| author_facet | Luis M. da Silva Andréa Coy‐Canguçu Layde R. Paim Adriana A. Bau Camila Nicolela Geraldo Martins Stephan Pinheiro Vinicius Citeli Ribeiro Walter E. Magalhães Rocha Jose R. Mattos‐Souza Roberto Schreiber Lígia Antunes‐Correa Andrei Sposito Wilson Nadruz Celso D. Ramos Tomas Neilan Michael Jerosch‐Herold Otávio R. Coelho‐Filho |
| author_sort | Luis M. da Silva |
| collection | DOAJ |
| description | Background 123Iodine‐meta‐iodobenzylguanidine scintigraphy is useful for assessing cardiac autonomic dysfunction and predict outcomes in heart failure (HF). The relationship of cardiac sympathetic function with myocardial remodeling and diffuse fibrosis remains largely unknown. We aimed to evaluate the cardiac sympathetic function of patients with HF and its relation with myocardial remodeling and exercise capacity. Methods and Results Prospectively enrolled patients with HF (New York Heart Association class II–III) were stratified into HF with preserved left ventricular ejection fraction [LVEF] ≥45%) and reduced LVEF. Ventricular morphology/function and myocardial extracellular volume (ECV) fraction were quantified by cardiovascular magnetic resonance, global longitudinal strain by echocardiography, cardiac sympathetic function by heart‐to‐mediastinum ratio from 123iodine‐meta‐iodobenzylguanidine scintigraphy. All participants underwent cardiopulmonary exercise testing. The cohort included 33 patients with HF with preserved LVEF (LVEF, 60±10%; NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], 248 [interquartile range, 79–574] pg/dL), 28 with HF with reduced LVEF (LVEF, 30±9%; NT‐proBNP, 743 [interquartile range, 250–2054] pg/dL) and 20 controls (LVEF, 65±5%; NT‐proBNP, 40 [interquartile range, 19–50] pg/dL). Delayed (4 hours) 123iodine‐meta‐iodobenzylguanidine heart‐to‐mediastinum ratio was lower in HF with preserved LVEF (1.59±0.25) and HF with reduced LVEF (1.45±0.16) versus controls (1.92±0.24; P<0.001), and correlated negatively with diffuse fibrosis assessed by ECV (R=−0.34, P<0.01). ECV in segments without LGE was increased in HF with preserved ejection fraction (0.32±0.05%) and HF with reduced left ventricular ejection fraction (0.31±0.04%) versus controls (0.28±0.04, P<0.05) and was associated with the age‐ and sex‐adjusted maximum oxygen consumption (peak oxygen consumption); (R=−0.41, P<0.01). Preliminary analysis indicates that cardiac sympathetic function might potentially act as a mediator in the association between ECV and NT‐proBNP levels. Conclusions Abnormally low cardiac sympathetic function in patients with HF with reduced and preserved LVEF is associated with extracellular volume expansion and decreased cardiopulmonary functional capacity. |
| format | Article |
| id | doaj-art-ba692a643af94fca9c1e76548e13e803 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-ba692a643af94fca9c1e76548e13e8032025-08-20T03:49:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-07-01131410.1161/JAHA.124.035264Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart FailureLuis M. da Silva0Andréa Coy‐Canguçu1Layde R. Paim2Adriana A. Bau3Camila Nicolela Geraldo Martins4Stephan Pinheiro5Vinicius Citeli Ribeiro6Walter E. Magalhães Rocha7Jose R. Mattos‐Souza8Roberto Schreiber9Lígia Antunes‐Correa10Andrei Sposito11Wilson Nadruz12Celso D. Ramos13Tomas Neilan14Michael Jerosch‐Herold15Otávio R. Coelho‐Filho16Faculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilCardiovascular Imaging Research Center, Division of Cardiology and Department of Radiology, Massachusetts General Hospital Harvard Medical School Boston MA USANon‐Invasive Cardiovascular Imaging Program, Department of Radiology Brigham and Women’s Hospital and Harvard Medical School Boston MA USAFaculdade de Ciências Médicas Universidade Estadual de Campinas São Paulo BrazilBackground 123Iodine‐meta‐iodobenzylguanidine scintigraphy is useful for assessing cardiac autonomic dysfunction and predict outcomes in heart failure (HF). The relationship of cardiac sympathetic function with myocardial remodeling and diffuse fibrosis remains largely unknown. We aimed to evaluate the cardiac sympathetic function of patients with HF and its relation with myocardial remodeling and exercise capacity. Methods and Results Prospectively enrolled patients with HF (New York Heart Association class II–III) were stratified into HF with preserved left ventricular ejection fraction [LVEF] ≥45%) and reduced LVEF. Ventricular morphology/function and myocardial extracellular volume (ECV) fraction were quantified by cardiovascular magnetic resonance, global longitudinal strain by echocardiography, cardiac sympathetic function by heart‐to‐mediastinum ratio from 123iodine‐meta‐iodobenzylguanidine scintigraphy. All participants underwent cardiopulmonary exercise testing. The cohort included 33 patients with HF with preserved LVEF (LVEF, 60±10%; NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], 248 [interquartile range, 79–574] pg/dL), 28 with HF with reduced LVEF (LVEF, 30±9%; NT‐proBNP, 743 [interquartile range, 250–2054] pg/dL) and 20 controls (LVEF, 65±5%; NT‐proBNP, 40 [interquartile range, 19–50] pg/dL). Delayed (4 hours) 123iodine‐meta‐iodobenzylguanidine heart‐to‐mediastinum ratio was lower in HF with preserved LVEF (1.59±0.25) and HF with reduced LVEF (1.45±0.16) versus controls (1.92±0.24; P<0.001), and correlated negatively with diffuse fibrosis assessed by ECV (R=−0.34, P<0.01). ECV in segments without LGE was increased in HF with preserved ejection fraction (0.32±0.05%) and HF with reduced left ventricular ejection fraction (0.31±0.04%) versus controls (0.28±0.04, P<0.05) and was associated with the age‐ and sex‐adjusted maximum oxygen consumption (peak oxygen consumption); (R=−0.41, P<0.01). Preliminary analysis indicates that cardiac sympathetic function might potentially act as a mediator in the association between ECV and NT‐proBNP levels. Conclusions Abnormally low cardiac sympathetic function in patients with HF with reduced and preserved LVEF is associated with extracellular volume expansion and decreased cardiopulmonary functional capacity.https://www.ahajournals.org/doi/10.1161/JAHA.124.035264cardiac magnetic resonancecardiac sympathetic functionheart failureinterstitial fibrosis |
| spellingShingle | Luis M. da Silva Andréa Coy‐Canguçu Layde R. Paim Adriana A. Bau Camila Nicolela Geraldo Martins Stephan Pinheiro Vinicius Citeli Ribeiro Walter E. Magalhães Rocha Jose R. Mattos‐Souza Roberto Schreiber Lígia Antunes‐Correa Andrei Sposito Wilson Nadruz Celso D. Ramos Tomas Neilan Michael Jerosch‐Herold Otávio R. Coelho‐Filho Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac magnetic resonance cardiac sympathetic function heart failure interstitial fibrosis |
| title | Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure |
| title_full | Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure |
| title_fullStr | Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure |
| title_full_unstemmed | Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure |
| title_short | Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure |
| title_sort | impaired cardiac sympathetic activity is associated with myocardial remodeling and established biomarkers of heart failure |
| topic | cardiac magnetic resonance cardiac sympathetic function heart failure interstitial fibrosis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.035264 |
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