Predictive impacts of chronic kidney disease and cardiac sympathetic nervous activity on lethal arrhythmic events in chronic heart failure

Amami, Kazuaki; Yamada, Shuichi; Yoshihisa, Akiomi; Kaneshiro, Takashi; Hijioka, Naoko; Nodera, Minoru; Nehashi, Takeshi; Takeishi, Yasuchika

doi:10.1111/anec.12900

Cited by 4 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the results of this study including the additional analysis, it is speculated that the patients with relatively preserved renal function, or not contraindicated to use diuretics (e.g. patients with hypertension and preserved renal function, often complicated with LVH) can be potentially reversible causes of cardiac sympathetic dysfunction among TAVI candidates for severe AS (27)(28)(29). The close relation of renal function and cardiac sympathetic nerve activity has been widely known for HF with both preserved and reduced LV function, so called cardiorenal syndrome (30).…”

Section: Discussionmentioning

confidence: 99%

Cardiac Sympathetic Nerve Function in Patients with Severe Aortic Stenosis Prior and After Transcatheter Aortic Valve Implantation

Egi,

Fukushima,

Matsusaka

et al. 2024

Annals of Nuclear Cardiology

View full text Add to dashboard Cite

Background: While the non-invasive assessment of cardiac sympathetic nerve dysfunction is readily accessible, its applicability in invasive intervention for structural heart disease has received limited investigation. Our study aimed to clarify the cardiac sympathetic nerve function in patients with severe Aortic stenosis (AS) and its postoperative changes after transcatheter aortic valve implantation (TAVI) using 123 I-metaiodobenzylguanidine scintigraphy (MIBG) in combination with 5-year mortality prediction model. Methods: Consecutive 26 patients (83 ± 5ys, male 4) with severe AS who underwent MIBG prior TAVI procedures were retrospectively enrolled. Of those, 15 patients underwent postoperative-follow up MIBG. The early and delayed heart-to-mediastinum ratio (e-and d-H/M), and washout rate (WR) were obtained from MIBG planner imaging. The MIBG 5-year mortality prediction model was employed to compare pre and after TAVI. Cardiac function and wall thickness were evaluated with transthoracic echocardiography. Results: Preoperative e-H/M, d-H/M, and WR were 2.4±0.5, 2.3±0.4, and 29±14% respectively, and WR showed significant correlation to left ventricular ejection fraction (LVEF) and brain natriuretic peptide (BNP) (r=-0.4 and 0.6; p=0.03, and 0.001 for LVEF and BNP, respectively). 102±28 days after TAVI, either H/M or WR did not show significant improvement among enrolled patients (2.5±0.3, 2.3±0.4, and 30±11% for e-, d-H/M, and WR for after TAVI), while the BNP level was significantly reduced (128±691 and 94±194 pg/dl, for pre vs. after, p=0.008). Five patients showed a significant recovery in WR (37.0±13.8 and 28.8±8.5% for pre and post, p=0.04), and left ventricular wall thickness was significantly thinner compared to those who did not recover (15.2±3.2 vs 11.2±2.4, p=0.02; 14.2±2.9 vs 10.8±1.8, p=0.02 for intraventricular septum and posterior wall, respectively). In 5-year prediction risk model, 7 patients showed a significant reduction in mortality risk, and the patients who did not show risk reduction had significantly reduced renal function (eGFR 57.5±18.8 vs. 38.2±11.3 ml/min/1.73m 2 , p=0.03 for recovered vs. not recovered). Conclusion: After a 3-month follow-up after TAVI, diverse response in cardiac MIBG parameters were observed among patients with severe AS, despite successful valve replacement. Cardiac MIBG serves as a non-invasive tool that can comprehensively evaluate and surrogate the severity of heart failure resulting from a multi-factorial condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiac Sympathetic Nerve Function in Patients with Severe Aortic Stenosis Prior and After Transcatheter Aortic Valve Implantation

Egi,

Fukushima,

Matsusaka

et al. 2024

Annals of Nuclear Cardiology

View full text Add to dashboard Cite

show abstract

“…Chronic activation of the SNS is prevalent in patients with T2D, ischemic heart disease, HF, hypertension, and CKD and results in fluid retention, endothelial dysfunction, and increased arterial stiffness [110]; chronic SNS activation is associated with poor prognosis [111][112][113][114][115]. The SNS is regulated, in part, by the kidneys, as renal stress results in increased signaling to the brain, stimulating the sympathetic center and enhancing sympathetic outflow [110].…”

Section: Reduction In Sns Activationmentioning

confidence: 99%

Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Cardiovascular Disease and Chronic Kidney Disease

Rastogi

Januzzi

2023

JCM

View full text Add to dashboard Cite

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to improve cardiovascular and renal outcomes in patients with established cardiovascular disease, chronic kidney disease (CKD), and heart failure (HF) with reduced or preserved ejection fraction. Clinical benefit has been substantiated in patients with and without type 2 diabetes (T2D). Consequently, SGLT2is have an increasingly important role in HF and CKD management that extends beyond T2D treatment. Their pleiotropic pharmacological effects underlying their cardiovascular and renal benefits are not completely understood but include significant effects beyond blood glucose reduction. SGLT2is inhibit the reabsorption of glucose and sodium in the proximal tubule which, in addition to lowering blood glucose, activates tubuloglomerular feedback, leading to reduced glomerular hydrostatic pressure and the mitigation of glomerular filtration rate loss. SGLT2is have diuretic and natriuretic effects, leading to decreased blood pressure, preload, and left ventricular (LV) filling pressure, and improvements in other surrogates of afterload. In HF, SGLT2is mitigate the risks of hyperkalemia and ventricular arrhythmia and improve LV dysfunction. SGLT2is also reduce sympathetic tone and uric acid levels, increase hemoglobin levels, and are postulated to have anti-inflammatory properties. This narrative review discusses the multifactorial and interrelated pharmacological mechanisms underlying the cardiovascular and renal benefits of SGLT2is.

show abstract

“…More recently, Marsico et al showed that, in a population of 263 patient with mild-to-severe HF, 123 I-MIBG uptake was significantly reduced in HF patients with severely impaired renal function compared to HF subjects with preserved renal function [39]. Furthermore, the combination of chronic kidney dysfunction and impaired cardiac sympathetic nervous activity, assessed by 123 I-MIBG scintigraphy, has been shown to have a high prognostic value in the prediction of lethal arrhythmic events in HF patients [40]. In conclusion, these results suggest that impaired cardiac sympathetic innervation might contribute to worsen prognosis in patients with HF and concomitant renal dysfunction.…”

Section: I-mibg Imaging In Hf Associated To Chronic Kidney Diseasementioning

confidence: 99%

123I-MIBG imaging in heart failure: impact of comorbidities on cardiac sympathetic innervation

Gargiulo

Acampa

Asile

et al. 2022

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Purpose Heart failure (HF) is a primary cause of morbidity and mortality worldwide, with significant impact on life quality and extensive healthcare costs. Assessment of myocardial sympathetic innervation function plays a central role in prognosis assessment in HF patients. The aim of this review is to summarize the most recent evidence regarding the clinical applications of iodine-123 metaiodobenzylguanidine (123I-MIBG) imaging in patients with HF and related comorbidities. Methods A comprehensive literature search was conducted on PubMed and Web of Science databases. Articles describing the impact of 123I-MIBG imaging on HF and related comorbidities were considered eligible for the review. Results We collected several data reporting that 123I-MIBG imaging is a safe and non-invasive tool to evaluate dysfunction of cardiac sympathetic neuronal function and to assess risk stratification in HF patients. HF is frequently associated with comorbidities that may affect cardiac adrenergic innervation. Furthermore, HF is frequently associated with comorbidities and chronic conditions, such as diabetes, obesity, kidney disease and others, that may affect cardiac adrenergic innervation. Conclusion Comorbidities and chronic conditions lead to more severe impairment of sympathetic nervous system in patients with HF, with a negative impact on disease progression and outcome. Cardiac imaging with 123I-MIBG can be a useful tool to reduce morbidity and prevent adverse events in HF patients.

show abstract

Predictive impacts of chronic kidney disease and cardiac sympathetic nervous activity on lethal arrhythmic events in chronic heart failure

Cited by 4 publications

References 31 publications

Cardiac Sympathetic Nerve Function in Patients with Severe Aortic Stenosis Prior and After Transcatheter Aortic Valve Implantation

Cardiac Sympathetic Nerve Function in Patients with Severe Aortic Stenosis Prior and After Transcatheter Aortic Valve Implantation

Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Cardiovascular Disease and Chronic Kidney Disease

123I-MIBG imaging in heart failure: impact of comorbidities on cardiac sympathetic innervation

Contact Info

Product

Resources

About