What will be the role of I-123 MIBG in improving the outcome of medically treated heart failure patients?

Role of I-123 MIBG in sepsis-induced cardiomyopathy

“…24 Despite extensive, almost all of the literature on utility of 123 I-MIBG-based imaging are gathered from patients with chronic systolic heart failure. Relatively few data for 123 I-MIBG imaging are available for patients with isolated diastolic dysfunction or acute illness-related cardiomyopathy such as septic cardiomyopathy.…”

Cardiac sympathetic imaging in the diagnosis of cardiac autonomic neuropathy in pre-diabetes

“…The capability of I-123 MIBG to stratify risk of death, heart failure progression, and life-threatening cardiac arrhythmias 20 is well established in patients with heart failure, 18,21 including diabetic patients with heart failure. 22 Abnormality of cardiac sympathetic nerve function in diabetic subjects in the absence of clinical heart failure has also been well documented.…”

Cardiac autonomic imaging with SPECT tracers

“…94 123 I-mIBG imaging could instead be used to determine whether or not a particular therapy is working, perhaps increase doses more aggressively or determine if device therapies or transplantation are needed. 95,96 Matsui et al 97 studied patients with severe cardiomyopathy, and found that after 6 months of optimal medical therapy, a worsening H/M had, with BNP, the highest predictive value for CD, suggesting that such patients may have benefited from earlier device therapy or transplant. At the same time, a recent study by Drakos et al 98 of patients with an LVAD found that clinical improvement paralleled improvement in tracer uptake, suggesting that 123 ImIBG could guide which patients need transplant, or instead who might be able to have the device discontinued.…”