Relationship between impaired cardiac sympathetic activity and spatial dyssynchrony in patients with non-ischemic heart failure: assessment by MIBG scintigraphy and tagged MRI

J Nucl Cardiol. 2013 Aug;20(4):600-8. doi: 10.1007/s12350-013-9715-1. Epub 2013 May 8.


Background: Impairment of cardiac sympathetic activity has various detrimental effects on cardiac function. The purpose was to investigate the relationship between left ventricular (LV) dyssynchrony and cardiac sympathetic activity in non-ischemic heart failure (HF).

Methods: Twenty-seven patients with non-ischemic HF were enrolled. Cardiac sympathetic activity was assessed by heart-to-mediastinum ratio (H/M ratio) on (123)I-Metaiodobenzylguanidine scintigraphy. LV dyssynchrony was assessed by cross-correlation analysis of time curves of myocardial circumferential strains delivered from cine-tagging MR images. Temporal dyssynchrony was defined as contraction delay between septal and lateral segments >110 milliseconds. Spatial dyssynchrony was defined as the negative value of the maximum correlation for the two strain time curves.

Results: H/M ratio was significantly lower for patients with spatial dyssynchrony compared to patients without (1.8 ± 0.3 vs 2.1 ± 0.3, P < .05). There was no difference between patients with and without temporal dyssynchrony (2.0 ± 0.2 vs 2.0 ± 0.3). The incidence of spatial dyssynchrony was significantly higher in patients with H/M ratio <2.0 than those whose ratios were ≥2.0 (75% vs 20%, P = .001). There was no difference in the incidence of temporal dyssynchrony between the two groups (17% vs 20%).

Conclusion: Impairment of cardiac sympathetic activity was found to be associated with spatial dyssynchrony in patients with non-ischemic HF.

MeSH terms

  • 3-Iodobenzylguanidine*
  • Adolescent
  • Adult
  • Aged
  • Cardiac Resynchronization Therapy
  • Female
  • Heart / diagnostic imaging
  • Heart / physiopathology
  • Heart Failure / diagnostic imaging*
  • Heart Failure / physiopathology*
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Heart-Assist Devices
  • Humans
  • Iodine Radioisotopes
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Sympathetic Nervous System / pathology*
  • Time Factors
  • Young Adult


  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine