Incremental prognostic value of myocardial neuroadrenergic damage in patients with chronic congestive heart failure: An iodine-123 meta-iodobenzylguanidine scintigraphy study

123I-MIBG cardiac sympathetic imaging provides further insight into cardiorenal interactions in systolic heart failure patients

“…The study also demonstrated that in a substantial portion of these patients treated for heart failure, reductions in left ventricular ejection fraction were accompanied by a progressive impairment of cardiac sympathetic activation reflecting an increase cardiac risk. 12 When systolic function progressively decreases then the increase in circulating epinephrine and norepinephrine levels strive to prevent a further decline in cardiac stroke volume by stimulating b1-mediated myocyte contraction. 13 This compensatory mechanism to maintain myocardial contractility and thus cardiac output, however, may be detrimental in the further course and the myocardium commences protecting itself from permanent adrenergic overstimulation by a downregulation of myocardial b1receptors.…”