Congestive Heart Failure Clinical Trial
Official title:
Cardiac Resynchronization and MIBG Imaging
Subjects were recruited if their healthcare provider decided that they needed treatment with a special Internal Cardiac Defibrillator (ICD) called a biventricular ICD. The investigators did this study to see if part of the nerve organ, called the sympathetic nervous system, may be responsible for the improvement seen in patients that receive biventricular pacing. The investigators had three ways to measure sympathetic nervous activity: 1) by using a special blood sample, 2) by monitoring heart rhythm, and 3) by performing a special heart scan.
The Specific Aim #1 of this study is to assess, with 123iodine metaiodobenzylguanidine
(123I-MIBG imaging), whether cardiac resynchronization therapy (CRT) rebalances and improves
the integrity and function of sympathetic nerve terminals in the failing myocardium. The
study will test the hypothesis that resynchronization of biventricular contractility
attenuates excessive sympathetic drive, and improves autonomic function and cardiac
performance.
The Specific Aim #2 of this study is to determine the relationship between 123I-MIBG
labeling of sympathetic activity and physiological measures of cardiopulmonary and autonomic
function. This aim is to test the hypothesis that impaired cardiac sympathetic activity,
determined by 123I-MIBG imaging will be associated with poorer submaximal exercise gas
exchange (higher ventilation - carbon dioxide (CO2) slopes, low end tidal CO2, reduced
oxygen pulse and a more rapid frequency response) as well as reduced heart rate power
spectral frequencies, a blunted response to positional changes and a delayed heart rate
recovery.
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