Nicolò Salvi

Role of cardiac 123I-mIBG imaging in predicting arrhythmic events in stable chronic heart failure patients with an ICD

BackgroundDespite therapeutic improvement, the prognosis of chronic heart failure (CHF) remains unfavorable partly due to arrhythmia and sudden cardiac death (SCD). This prospective study evaluated myocardial 123I-meta-iodobenzylguanidine (123I-mIBG) scintigraphy as a predictor of arrhythmic events (AE) in CHF patients.Methods170 CHF patients referred for implantable cardioverter-defibrillator (ICD) implantation for both primary and secondary prevention were enrolled. All patients underwent planar and SPECT imaging. Early and late heart-to-mediastinum (H/M) ratio, 123I-mIBG washout (WO), early and late summed SPECT scores were calculated The primary endpoint was an AE: sustained ventricular tachycardia, resuscitated cardiac arrest, appropriate ICD therapy or SCD. The secondary endpoint was appropriate ICD therapy.ResultsDuring a median follow-up of 23.3 months, 69 patients experienced an AE. Early summed score (ESS) was the only independent predictor of AE [HR 1.023 (1.003-1.043)]. Focussing on only patients with an ICD for primary prevention, ESS was the only independent predictor of AE [HR 1.028 (1.007-1.050)]. 123I-mIBG-derived parameters failed to be independent predictors of appropriate ICD therapy. However there was a “bell-shaped” relation between 123I-mIBG scintigraphy-derived parameters and AE and appropriate ICD therapy, i.e., those with intermediate 123I-mIBG abnormalities tended to be at higher risk of events.ConclusionAlthough SPECT 123I-mIBG scintigraphy was associated with AE in CHF patients with ICD implantation for primary and secondary prevention, no association was found between 123I-mIBG scintigraphy-derived parameters and appropriate ICD therapy.

EKG ABNORMALITIES DISTRIBUTION BETWEEN COMPETITIVE ATHLETES, NON COMPETITIVE ATHLETES AND NON ATHLETES IN A POPULATION OF 12,000 YOUNG ITALIAN STUDENTS

Introduction: The European Society of Cardiology recommends cardiovascular screening to competitive athletes. In young population the execution of 12-lead ECG screening is still controversial. Hypothesis: The aim of our study is to evaluate the distribution of ECG abnormalities between competitive athletes, non competitive athletes and non athletes. Methods: From October 2010 to October 2015, we evaluated prospectively 11916 high school students (age 17.2 ± 2.4 years old; 45.9% male): 4533 (38.04 %) non athletes (G-A), 4936 (41.42 %) non competitive athletes (G-B) and 2447 (20.54%) competitive athletes (G-C). They were screened using 12-lead ECG. The statistical difference was considered significant only for p-value l this suggest that an ECG screening is recommended also in non athletes.

RISK STRATIFICATION FOR SUDDEN CARDIAC DEATH IN PATIENTS WITH HEART FAILURE: ROLE FOR 123-IODINE METAIODOBENZYLGUANIDINE IMAGING AND CARDIAC MAGNETIC RESONANCE IMAGING. A REAL WORLD SINGLE CENTRE EXPERIENCE

Implantable cardioverter defibrillator (ICD) is recommended for the prevention of sudden cardiac death (SCD) in patients with heart failure, basing mainly on ejection fraction (EF). However, the latter has low sensibility and specificity. 123-iodine metaiodobenzylguanidine (123-I MIBG) imaging,