Background: The status of cardiac sympathetic nerve activity in patients with diastolic heart failure has not been fully understood. 123-I-metaiodobenzylguanidine cardiac images are valuable for evaluating cardiac sympathetic nerve activity.
Methods: We obtained 123-I-metaiodobenzylguanidine cardiac images from 34 consecutive patients with moderate heart failure and an ejection fraction of > or = 45%.
Results: The decay-corrected washout rate of 123-I-metaiodobenzylguanidine correlated with each plasma concentration of brain natriuretic peptide (standardized correlation coefficient=0.305, p<0.05), New York Heart Association functional class (standardized correlation coefficient=0.364, p<0.02), and exercise capacity (standardized correlation coefficient=-0.388, p<0.04). A multiple regression analysis revealed that the washout rate independently predicted plasma concentration of brain natriuretic peptide (standardized regression coefficient=0.367, p<0.02). In a univariate regression, the washout rate did not significantly correlate with the presence of ischemic heart disease (p=0.254); in a multivariate regression, the presence of ischemic heart disease did not predict the washout rate. For the 14 patients with sinus rhythm, there was a marginal negative correlation between the E/A velocity ratio of the transmitral flow and washout rate (standardized correlation coefficient=-0.518, p<0.07).
Conclusions: In diastolic heart failure, cardiac sympathetic nerve activity increases proportionally to severity of the disease.