CARDIAC SYMPATHETIC ACTIVITY, MYOCARDIAL PERFUSION AND HEART CONTRACTILITY IN PATIENTS WITH ISCHAEMIC AND NON-ISCHAEMIC HEART FAILURE
Purpose: to assess the cardiac sympathetic activity, perfusion and contractility in ischemic and nonischemic chronic heart failure patients by using a radionuclide methods. Material and Methods. The study included 33 heart failure patients with NYHA class III and ischemic (n=13.39%) and non-ischemic (n=20.61%) heart failure. All patients underwent 123I-MIBG imaging, myocardial perfusion imaging with 99mTc-MIBI and gated blood-pool single-photon emission computed tomography. Based on 123I-MIBG study heart to mediastinum ratio as well as 123I-MIBG washout rate were calculated. According to the myocardial perfusion imaging, Summed Rest Score was evaluated. Systolic and diastolic functions and ejection fraction as well as mechanical intraventricular dyssynchrony of both ventricles were analyzed by gated blood-pool single-photon emission computed tomography. Results. There was no statistically significant difference of hemodynamic parameters between the groups. In the first group, which include patients with ischemic heart failure, there were found the following correlations: washout rate and left ventricular end-diastolic volume (0.75; p<0.05), washout rate and left ventricular end-systolic volume (0.68; p<0.05), heart to mediastinum ratio and right ventricular ejection fraction (-0.57; p<0.05). In the group of patients with non-ischemic heart failure there were the following correlation: heart to mediastinum ratio and left ventricular end-systolic volume (-0.77; p<0.05), heart to mediastinum ratio and left ventricular ejection fraction (0.77, p<0.05), heart to mediastinum ratio and right ventricular ejection fraction (0.62, p<0.05), washout rate and left ventricular interventricular dyssynchrony (0.6; p<0.05). Conclusion. It was found out that heart failure patients were characterized by a correlation between sympathetic activity and volumes, hemodynamics and contractility of heart ventricles. The relationship between the cardiac sympathetic activity and myocardial perfusion as well as contractility depend on the etiology of chronic heart failure.