Adrenergic nervous system imaging in hf management

The prevalence of heart failure (HF) has increased in the last decades, particularly in the older population. In parallel with the increase in prevalence, costs with infrastructure to hospitalize and treat these patients have also increased. Coronary heart disease remains the most directly related to HF; however, other causes and comorbidities should be taken into account depending on the region studied. Cardiac adrenergic assessment through imaging examinations allows us to get a few robust parameters using semiquantitative analysis which have a great potential in the evaluation of abnormal findings. Myocardial scintigraphy with 123I-mIBG plays an important role in the assessment of HF for risk-stratifying cardiac events. mIBG is an analog of norepinephrine (NE), which can be used to evaluate cardiac sympathetic activity by analyzing the decrease in adrenoreceptor expression in HF. Standardization and validation may contribute to its acceptance and routine use in clinical practice.