Coutinho Cruz, MAbreu, APortugal, GSanta-Clara, HSilva Cunha, POliveira, MMSantos, VOliveira, LRio, PRodrigues, IMorais, LACruz Ferreira, RMota Carmo, M2020-02-062020-02-062019J Nucl Cardiol. 2019 Jun;26(3):869-879.http://hdl.handle.net/10400.17/3422BACKGROUND: Heart failure (HF) is associated with cardiac autonomic denervation (AD), which can be non-invasively assessed by 123I-metaiodobenzylguanidine (123I-mIBG) scintigraphy and has prognostic implications. We aimed to study the relationship between myocardial contractility assessed by global longitudinal strain (GLS) and AD assessed by 123I-mIBG scintigraphy in advanced HF. METHODS/RESULTS: BETTER-HF is a prospective randomized clinical trial including HF patients (pts) submitted to cardiac resynchronization therapy (CRT) who are submitted to a clinical, echocardiographic, and scintigraphic assessment before and 6 months after CRT. 81 pts were included. An echocardiographic response (absolute increase in left ventricular ejection fraction ≥ 10%) was observed in 73.7% of pts. A higher baseline late heart-to-mediastinum ratio (HMR) was associated with a better echocardiographic response. There was a significant association between late HMR and GLS at baseline and 6 months. At baseline, GLS had an AUC of 0.715 for discrimination for a late HMR < 1.6. A GLS cut-off of - 9% maximized the likelihood of correctly classifying a pt as having severe AD (HMR < 1.6). CONCLUSION: Myocardial contractility as assessed by GLS is moderately correlated with AD as assessed by 123I-mIBG scintigraphy and has a good discrimination for the identification of severe cardiac denervation. GLS may allow for a more readily accessible estimation of the degree of AD in advanced HF pts.engHSM CAR3-IodobenzylguanidineAdultAgedAged, 80 and overAutonomic Nervous System Diseases / diagnostic imagingAutonomic Nervous System Diseases / etiologyCardiac Resynchronization TherapyFemaleMaleHumansHeart Failure / diagnostic imagingHeart Failure / physiopathologyHeart Failure / therapyMiddle AgedRadionuclide ImagingRadiopharmaceuticalsStroke Volume / physiologyVentricular Function, Left / physiologyjournal article10.1007/s12350-017-1148-9