Impact of concomitant medication use on myocardial 123I-mIBG imaging results in patients with heart failure
Impact of concomitant medication use on myocardial 123I-mIBG imaging results in patients with heart failure
复制标题
心力衰竭患者合并用药对心肌 123I-mIBG 显像结果的影响
DOI：
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发表时间：
2017
影响因子：
1.5
通讯作者：
Carol Tseng
中科院分区：
文献类型：
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作者：
A. Jacobson;S. White;M. Travin;Carol Tseng
引言干扰交感神经元去甲肾上腺素摄取和储存的药物，如神经精神病学（NP）和拟交感神经胺，最有可能影响碘-123间碘苄胍（123 I-mIBG）的心脏摄取。本研究通过测量ADMIRE-HF扩展（X）研究中心力衰竭（HF）患者的心脏123 I-mIBG摄取，检查了这些和其他报告影响123 I-mIBG摄取的药物。方法将961例HF患者基线合并用药分为5组：钙通道阻滞剂、NP药物、激动剂和拟交感神经药、拮抗剂和其他抗高血压药物。NP药物进一步细分为预期对去甲肾上腺素转运蛋白（NET）功能具有高和低影响的药物。比较各组心肌123 I-mIBG心脏/纵隔（H/M）摄取比值。还检查了中位2年随访期间药物组对全因（AC）和心源性死亡的H/M比值的预后价值的影响。结果共有283例（29%）患者使用至少一种钙通道阻滞剂、NP药物、激动剂或拟交感神经药物。这些患者的平均H/M比低于其他研究患者（1.42±0.20 vs. 1.45±0.20; P=0.022）。然而，两组的2年AC死亡率相同[11.3%（95%置信区间：7.5-15.2%）vs. 11.8%（95%置信区间：9.2-14.4%）]。在药物类别方面，使用和未使用NP药物、激动剂、钙通道阻滞剂和拮抗剂的患者之间的平均H/M比值无显著差异。在所有类别中，H/M比值大于或等于1.60的患者具有较低的AC和心源性死亡率。使用更高效力（用于NET抑制）NP药物的患者具有显著更低的H/M比值，但H/M比值大于或等于1.60的预后意义不变。结论只有少数高效价NET抑制NP药物对123 I-mIBG心肌显像结果有可测量的影响。似乎没有依据限制在转诊接受心脏123 I-mIBG成像的HF患者中使用钙通道阻滞剂和激动剂呼吸药物。
Introduction Medications that interfere with sympathetic neuronal norepinephrine uptake and storage, such as neuropsychiatrics (NP) and sympathomimetic amines, are most likely to affect cardiac uptake of iodine-123 metaiodobenzylguanidine (123I-mIBG). The present study examined these and other medications reported to affect 123I-mIBG uptake using measurements of cardiac 123I-mIBG uptake on the heart failure (HF) patients in the ADMIRE-HF extension (X) study. Methods Baseline concomitant medications taken by the 961 HF patients were categorized into five groups: calcium channel blockers, NP medications, &bgr; agonists and sympathomimetics, &agr; antagonists, and other antihypertensives. NP medications were further subcategorized into those expected to have high and low impact on norepinephrine transporter (NET) function. Myocardial 123I-mIBG heart/mediastinum (H/M) uptake ratios on 4 h planar images were compared among the groups. Impact of medication group on the prognostic value of the H/M ratio for all-cause (AC) and cardiac death during a median 2-year follow-up was also examined. Results A total of 283 (29%) patients were using at least one calcium channel blocker, NP medication, or &bgr; agonist or sympathomimetic. These patients had a lower mean H/M ratio than the other study patients (1.42±0.20 vs. 1.45±0.20; P=0.022). However, the 2-year AC mortality rates in the two groups were the same [11.3% (95% confidence interval: 7.5–15.2%) vs. 11.8% (95% confidence interval: 9.2–14.4%)]. In terms of medication categories, there were no significant differences in the mean H/M ratios between patients who did and did not use NP medications, &bgr; agonists, calcium channel blockers, and &agr; antagonists. Across all categories, patients with H/M ratio greater than or equal to 1.60 had lower AC and cardiac mortality. Patients using higher potency (for NET inhibition) NP medications had significantly lower H/M ratio values, but the prognostic significance of H/M ratio greater than or equal to 1.60 was unchanged. Conclusion Only a small number of higher potency NET-inhibiting NP medications have a measurable effect on the results of 123I-mIBG myocardial imaging. There appears to be no basis for restricting the use of calcium channel blockers and &bgr; agonist respiratory medications in HF patients referred for cardiac 123I-mIBG imaging.
影响因子：
158.5
作者：
SISSON, JC;FRAGER, MS;THOMPSON, NW
通讯作者：
THOMPSON, NW