Impact of the Number of Comorbidities on Cardiac Sympathetic
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In systolic heart failure (HF) patients, the number of comorbidities is not associated with alterations in cardiac adrenergic innervation, according to a study results found by a team of researchers from Italy.

They mentioned that, “HF is frequently associated with comorbidities. 123I-metaiodobenzylguanidine ( 123I-mIBG) imaging constitutes an effective tool to measure cardiac adrenergic innervation and to improve prognostic stratification in HF patients, including the risk of major arrhythmic events.

Although comorbidities have been individually associated with reduced cardiac adrenergic innervation, thus suggesting increased arrhythmic risk, very comorbid HF patients seem to be less likely to experience fatal arrhythmias.”

To evaluate the impact of the number of comorbidities on cardiac adrenergic innervation, assessed through 123I-mIBG imaging, in patients with systolic HF, researchers included a total of 269 HF patients with a mean age of 66±11 years who had undergone clinical examination, transthoracic echocardiography, and cardiac 123I-mIBG scintigraphy.

They documented the presence of 7 comorbidities/conditions (smoking, chronic obstructive pulmonary disease, diabetes mellitus, peripheral artery disease, atrial fibrillation, chronic ischemic heart disease, and chronic kidney disease) in the overall study population.

Highly comorbid patients presented a reduced late heart to mediastinum (H/M) ratio, while no significant differences emerged in terms of early H/M ratio and washout rate. Multiple regression analysis revealed that the number of comorbidities was not associated with mIBG parameters of cardiac denervation, which were correlated with age, BMI and left ventricular ejection fraction.

“These outcomes are consistent with the observation that very comorbid HF patients suffer a lower risk of sudden cardiac death,” the researchers concluded.