These results indicate that P-SAE could be useful to identify patients at risk for the transition from PAF to CAF.

Cardiac MIBG WR has a higher prognostic value than HRV parameters in patients with chronic HF. The combination of abnormal WR and n-VLFP would be useful to identify chronic HF patients at a higher risk of cardiac events.

Objective-To determine whether cardiac iodine-123 metaiodobenzylguanidine ( 123 I MIBG) imaging is useful in predicting the prognosis of patients with chronic heart failure. Design-Cardiac123 I MIBG imaging was done on entry to the study. The cardiac MIBG washout rate was calculated from anterior chest view images obtained 20 and 200 minutes after injection of the isotope. Study patients were divided into two groups with washout rates above and below 27% (the mean value + 2 SD obtained in 20 normal subjects), and were then followed up. Setting-Tertiary referral centre. Patients-79 patients with chronic heart failure in whom the left ventricular ejection fraction was less than 40%. Results-There were 37 patients in group 1 (washout rate of > 27%) and 42 in group 2 (< 27%). During a follow up period of between 1 and 52 months, eight patients died suddenly and five died of worsening heart failure in group 1, while none died in group 2; 13 patients in group 1 and four in group 2 were admitted to hospital for progressive heart failure. Kaplan-Meier analysis showed that group 1 had a significantly higher mortality and morbidity (p = 0.001 and p < 0.001, respectively) than group 2. Conclusions-Cardiac 123

An abnormal P-SAECG and elevated ANP level could be predictors of PAF development in patients with CHF.

n essential hypertension, changes in the morphology of the left ventricle (LV) are commonly observed, and are considered to be the result of adaptation to pressure overload. The changes have been classified into 4 geometric patterns based on the LV mass and wall thickness. 1 These geometric changes are consistent with progression of heart failure in an experimental model, 2 and furthermore, are considered to reflect the course of hypertensive heart failure. 3,4 On the other hand, it has been speculated that a disorder of myocardial energetic metabolism relates to progression of heart failure. 123 I-15-p-iodophenyl-3-(R,S)-methylpentadecanoic acid (I-123 BMIPP) is a radioisotope used for assessment of myocardial free fatty acid (FFA) metabolism and abnormal myocardial uptake of BMIPP has been reported in patients with heart failure. 13 However, Japanese Circulation Journal Vol.65, September 2001 it has not been clarified whether the pathophysiological adaptation of changing the LV morphology in hypertensive hearts is related to changes in myocardial FFA metabolism. MethodsThirty-five patients (21 men, 14 women; mean age: 61±11 years) who had a history of essential hypertension (blood pressure ≥160 mmHg at systole or 90 mmHg at diastole according to the WHO criteria) were enrolled. The patients were free of any symptoms of ischemic heart disease, valvular heart disease, or concomitant important diseases such as diabetes mellitus. Two patients with symptomatic congestive heart failure (New York Heart Association class II-III) who took some diuretics were included. The evaluations, including a detailed medical history, 12-lead ECG, urinalysis, and serum levels of urea nitrogen, creatinine, glucose, cholesterol, sodium, potassium and calcium, were performed in all subjects. An echocardiogram of adequate quality to assess LV morphologic characteristics was also obtained from all subjects. Patients who showed LV asymmetrical hypertrophy on the echocardiogram were excluded, as were patients with diabetes mellitus or renal failure. All patients in the study gave written informed consent.Echocardiography was performed using an ultrasonic sector scanner with 2.5-and 3.75-MHz transducers (SONOLAYER SSH-160A Toshiba Co, Japan The left ventricle's morphological adaptation to high blood pressure is classified into 4 patterns based on mass and wall thickness. The geometric changes caused by maladaptation to pressure overload possibly relate to progression of contractile dysfunction with abnormal energy metabolism. The present study assessed whether the geometric adaptation of the left ventricle (LV) to high blood pressure relates to changes in myocardial energy metabolism, especially free fatty acid (FFA) utilization. Thirty-five patients with essential hypertension underwent echocardiography and dual isotopes myocardial scintigraphy using iodine-123 labeled 15-p-iodophenyl-3-(R,S)-methylpentadecanoic acid (BMIPP, an analogue of a FFA) and . Systolic (endocardial fractional shortening; %FS) and diastolic indices (the ratio o...