In patients with ischemic or non-ischemic cardiomyopathy and left
ventricular ejection fraction <35%, 123I-metaiodobenzylguanidine (MIBG) imaging can
contribute to risk stratification, identifying those patients who are at high risk of sudden
cardiac death. This chapter reviews in the first part: recent publications concerning the
interest of 123I-MIBG scintigraphy to stratify patients suffering from heart failure and /
or ventricular tachyarrhythmia. Then, in a second part, we selected among different
therapeutic devices (implantable cardioverter-defibrillator – cardiac resynchronization
therapy) some publications about the effects of left ventricular assistance device on the
neuronal function of the heart in patients with severe cardiac impairment. Finally, the
interpretation of different parameters, such as Heart-Mediastinum Ratio (HMR) or
myocardial SPECT scores as regional LV dysinnervation using 123I-MIBG scintigraphy,
need some recommendations from the European and Japanese Cardio-Vascular
committees.
Keywords: Cardiac autonomous nervous system, Dilated cardiomyopathy, Heart
failure, Heart – mediastinum rate, Ischemic cardiomyopathy, Left ventricular
assistance device, MIBG, Scintigraphy, Ventricular tachyarrhythmia, Washout
ratio.