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Assessment of cardiac sympathetic activity by MIBG imaging in patients with heart failure: a clinical appraisal
  1. Pasquale Perrone-Filardi1,
  2. Stefania Paolillo1,
  3. Santo Dellegrottaglie1,
  4. Paola Gargiulo1,
  5. Gianluigi Savarese1,
  6. Caterina Marciano1,
  7. Laura Casaretti1,
  8. Milena Cecere1,
  9. Francesca Musella1,
  10. Elisabetta Pirozzi1,
  11. Antonio Parente1,
  12. Alberto Cuocolo2
  1. 1Department of Internal Medicine, Cardiovascular and Immunological Sciences, Federico II University, Naples, Italy
  2. 2Department of Biomorphological and Functional Sciences, Federico II University and SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
  1. Correspondence to Professor Pasquale Perrone-Filardi, Via Pansini, 5, I-80131 Naples, Italy; fpperron{at}


Cardiac sympathetic activity can be assessed by 123I-labelled meta-iodobenzylguanidine (MIBG) scintigraphy. Abnormalities of sympathetic cardiac activity have been shown in patients with heart failure, resulting in reduced MIBG uptake. Abnormal MIBG uptake predicts cardiac death, arrhythmias and all-cause mortality in patients with heart failure with a prognostic power incremental to that of conventional risk markers, and may identify patients at low risk of arrhythmias despite current guideline indications for implantable cardioverter defibrillator or patients at high risk for arrhythmias not fulfilling implantable cardioverter defibrillator indications. Prospective outcome studies are needed to assess whether MIBG imaging will have an impact on the mortality and morbidity of patients with heart failure.

  • Heart failure
  • MIBG
  • cardiac sympathetic system
  • hibernation
  • editorials
  • reviews
  • original manuscripts
  • myocardial viability
  • systolic dysfunction
  • pacemakers
  • atrial fibrillation
  • atrial flutter
  • atrioventricular block
  • cardiac function
  • systolic dysfunction
  • diastolic dysfunction
  • cardiac remodelling
  • haemodynamics
  • imaging and diagnostics
  • nuclear cardiology
  • radionuclide imaging

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.