Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St. JHOC 3230, Baltimore, MD, 21287, USA.
Department of Nuclear Medicine/Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
J Nucl Cardiol. 2020 Oct;27(5):1798-1801. doi: 10.1007/s12350-018-01475-0. Epub 2018 Oct 24.
As a scintigraphic approach evaluating cardiac nerve integrity, I-metaiodobenzylguanidine (I-mIBG) has been recently Food and Drug Administration approved. A great deal of progress has been made by the prospective ADMIRE-HF trial, which primarily demonstrated the association of denervated myocardium assessed by I-mIBG and cardiac events. However, apart from risk stratification, myocardial nerve function evaluated by molecular imaging should also be expanded to other clinical contexts, in particular to guide the referring cardiologist in selecting appropriate candidates for specific therapeutic interventions. In the present issue of the Journal of Nuclear Cardiology, the use of I-mIBG for identifying cardiomyopathy patients, which would most likely not benefit from ICD due to low risk of arrhythmias, is described. If we aim to deliver on the promise of cardiac innervation imaging as a powerful tool for risk stratification in a manner similar to nuclear oncology, studies such as the one reviewed here may imply an important step to lay the proper groundwork for a more widespread adoption in clinical practice.
作为一种评估心脏神经完整性的闪烁显像方法，I-间碘苄胍（I-mIBG）最近已获得美国食品和药物管理局的批准。前瞻性 ADMIRE-HF 试验取得了很大进展，该试验主要证明了 I-mIBG 评估的去神经支配心肌与心脏事件之间的关联。然而，除了风险分层外，通过分子成像评估心肌神经功能也应扩展到其他临床环境，特别是为了指导转诊心脏病专家选择特定治疗干预的合适候选者。在本期《核医学杂志》中，描述了使用 I-mIBG 来识别心肌病患者，由于心律失常风险低，这些患者不太可能因 ICD 而受益。如果我们旨在兑现心脏神经成像作为一种类似于核医学的强大风险分层工具的承诺，那么像这里所审查的研究这样的研究可能意味着为更广泛地在临床实践中采用奠定适当基础的重要一步。
