Impact of aging on cardiac sympathetic innervation measured by 123I-mIBG imaging in patients with systolic heart failure

Giuseppe Rengo, Gennaro Pagano, Dino Franco Vitale, Roberto Formisano, Klara Komici, Laura Petraglia, Valentina Parisi, G. D. Femminella, Claudio De Lucia, Stefania Paolillo, Alessandro Cannavo, E. Attena, Teresa Pellegrino, Santo Dellegrottaglie, Alessia Memmi, Bruno Trimarco, Alberto Cuocolo, Pasquale Perrone Filardi, D. Leosco, Nicola Ferrara

Research output: Contribution to journalArticlepeer-review


Purpose: Sympathetic nervous system (SNS) hyperactivity is a salient characteristic of chronic heart failure (HF) and contributes to the progression of the disease. Iodine-123 meta-iodobenzylguanidine (123I-mIBG) imaging has been successfully used to assess cardiac SNS activity in HF patients and to predict prognosis. Importantly, SNS hyperactivity characterizes also physiological ageing, and there is conflicting evidence on cardiac 123I-mIBG uptake in healthy elderly subjects compared to adults. However, little data are available on the impact of ageing on cardiac sympathetic nerve activity assessed by 123I-mIBG scintigraphy, in patients with HF. Methods and results: We studied 180 HF patients (age = 66.1 ± 10.5 years [yrs]), left ventricular ejection fraction (LVEF = 30.6 ± 6.3 %) undergoing cardiac 123I-mIBG imaging. Early and late heart to mediastinum (H/M) ratios and washout rate were calculated in all patients. Demographic, clinical, and echocardiographic data were also collected. Our study population consisted of 53 patients aged >75 years (age = 77.7 ± 4.0 year), 67 patients aged 62–72 years (age = 67.9 ± 3.2 years) and 60 patients aged ≤61 year (age = 53.9 ± 5.6 years). In elderly patients, both early and late H/M ratios were significantly lower compared to younger patients (p <0.05). By multivariate analysis, H/M ratios (both early and late) and washout rate were significantly correlated with LVEF and age. Conclusions: Our data indicate that, in a population of HF patients, there is an independent age-related effect on cardiac SNS innervation assessed by 123I-mIBG imaging. This finding suggests that cardiac 123I-mIBG uptake in patients with HF might be affected by patient age.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalEuropean Journal of Pediatrics
Publication statusAccepted/In press - Jun 10 2016


  • I-mIBG imaging
  • Age
  • Heart failure
  • Norepinephrine
  • Sympathetic nervous system

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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