2005 Volume 17 Issue 4 Pages 191-199
The aim of this study was to evaluate the relationship between congestive heart failure (CHF) and atrial fibrillation (AF) using iodine-123 metaiodobenzylguanidine (MIBG) scintigraphic imaging. Ninety-two AF patients (47 male and 45 female patients ; mean age, 67±13 years) who did not suffer from structural heart disease or myocardial ischemia underwent MIBG scintigraphy. Global MIBG uptake was assessed by measuring the heart-to-mediastinal ratio (H/M) and washout rate (WR) on planar images, and the abnormal score (AS) was calculated on delayed MIBG single photon emission computed tomography images. Echocardiography was performed within a week after MIBG scintigraphy, to measure left ventricular ejection fraction (EF) and deceleration time (DT) . The AF patients were divided into four groups : patients with permanent AF with (n = 23, group A) or without (n = 19, group B) a history of CHF, and patients with paroxysmal AF with (n =19, group C) or without (n = 39, group D) a history of CHF. Results : The H/M ratio was significantly lower in group A than in other groups (2.0 ± 0.6 vs. group B : 2.7 ± 0.6, group C : 2.3 ± 0.5, and group D : 2.6 ± 0.8, P < 0.05), and in group C than in group D (P < 0.05) . Similarly, the WR was significantly higher in group A than in groups B and C (45.9 ±2.0 vs. group B : 38.9 ± 1.9 and group C : 38.4 ± 2.3, P < 0.05) . The AS was the highest in group A (19.7 ± 8.2 vs. group B : 7.1 ± 6.6, P < 0.01; group C : 11.6 ± 10.6 and group D : 13.5 ± 9.0, P < 0.05) . The DT was significantly longer in group A than in groups B and D (222.0 ± 59.4 vs. group B : 179.5 ± 49.1, P < 0.05 and group D : 177.9 ± 37.1, P < 0.01), but did not differ between groups A and C (222.0 ± 59.4 vs. 197.4 ± 51.1) . There was no difference in EF among the groups. Although CHF with AF is associated with diastolic dysfunction, the progression to permanent AF from paroxysmal AF with CHF might be caused mainly by sympathetic nerve abnormality.
