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Article

Reclassification of Heart Failure with Preserved Ejection Fraction Following Cardiac Sympathetic Nervous System Activation: A New Cutoff Value of 58%

1
Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
2
Department of Cardiovascular Medicine, Nagoya City University West Medical Center, Nagoya 462-8508, Japan
3
Clinical Research Management Center, Nagoya City University Hospital, Nagoya 467-8601, Japan
*
Author to whom correspondence should be addressed.
Academic Editor: Emilio Quaia
Tomography 2022, 8(3), 1595-1607; https://doi.org/10.3390/tomography8030132
Received: 12 May 2022 / Revised: 14 June 2022 / Accepted: 16 June 2022 / Published: 18 June 2022
(This article belongs to the Section Cardiovascular Imaging)
Heart failure (HF) with preserved left ventricular ejection fraction (LVEF) is a heterogeneous syndrome. An LVEF of 50% is widely used to categorize patients with HF; however, this is controversial. Previously, we have reported that patients with an LVEF of ≥ 58% have good prognoses. Further, cardiac sympathetic nervous system (SNS) activation is a feature of HF. In this retrospective, observational study, the cardiac SNS activity of HF patients (n = 63, age: 78.4 ± 9.6 years; male 49.2%) with LVEF ≥ 58% (n = 15) and LVEF < 58% (n = 48) were compared using 123I-metaiodobenzylguanidine scintigraphy. During the follow-up period (median, 3.0 years), 18 all-cause deaths occurred. The delayed heart/mediastinum (H/M) ratio was significantly higher in the LVEF ≥ 58% group than in the LVEF < 58% group (2.1 ± 0.3 vs. 1.7 ± 0.4, p = 0.004), and all-cause mortality was significantly lower in patients in the former than those in the latter group (log-rank, p = 0.04). However, when these patients were divided into LVEF ≥ 50% (n = 22) and LVEF < 50% (n = 41) groups, no significant differences were found in the delayed H/M ratio, and the all-cause mortality did not differ between the groups (log-rank, p = 0.09). In conclusion, an LVEF of 58% is suitable for reclassifying patients with HF according to cardiac SNS activity. View Full-Text
Keywords: cardiac sympathetic nervous system; heart failure; left ventricular ejection fraction; metaiodobenzylguanidine; mortality cardiac sympathetic nervous system; heart failure; left ventricular ejection fraction; metaiodobenzylguanidine; mortality
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MDPI and ACS Style

Goto, T.; Nakayama, T.; Yamamoto, J.; Mori, K.; Shintani, Y.; Kikuchi, S.; Fujita, H.; Fukuta, H.; Seo, Y. Reclassification of Heart Failure with Preserved Ejection Fraction Following Cardiac Sympathetic Nervous System Activation: A New Cutoff Value of 58%. Tomography 2022, 8, 1595-1607. https://doi.org/10.3390/tomography8030132

AMA Style

Goto T, Nakayama T, Yamamoto J, Mori K, Shintani Y, Kikuchi S, Fujita H, Fukuta H, Seo Y. Reclassification of Heart Failure with Preserved Ejection Fraction Following Cardiac Sympathetic Nervous System Activation: A New Cutoff Value of 58%. Tomography. 2022; 8(3):1595-1607. https://doi.org/10.3390/tomography8030132

Chicago/Turabian Style

Goto, Toshihiko, Takafumi Nakayama, Junki Yamamoto, Kento Mori, Yasuhiro Shintani, Shohei Kikuchi, Hiroshi Fujita, Hidekatsu Fukuta, and Yoshihiro Seo. 2022. "Reclassification of Heart Failure with Preserved Ejection Fraction Following Cardiac Sympathetic Nervous System Activation: A New Cutoff Value of 58%" Tomography 8, no. 3: 1595-1607. https://doi.org/10.3390/tomography8030132

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