A new cardiac radiopharmaceutical being developed by GE Healthcare of Chalfont St. Giles, U.K., is showing an ability to predict cardiac events in symptomatic heart failure patients, according to results published in the May 18 issue of the Journal of the American College of Cardiology.
The ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) prospective study used iobenguane I-123 (AdreView) to indicate that there are four independent variables that contribute to the prediction of primary cardiac outcome events.
Study co-author Dr. Roxy Senior, director of cardiac research at Northwick Park Hospital in London, said increased cardiac sympathetic activity is a prominent feature of heart failure and is associated with progressive deterioration and remodeling of the myocardium, inexorable decline in left ventricular function, and worsening symptoms.
The results suggest that in appropriately selected patients with heart failure, scanning with AdreView can alert clinicians to the potential need for considering additional treatments, he added.
ADMIRE-HF was conducted in 96 centers in North America and Europe and consisted of two identical open-label phase III clinical studies evaluating the cardiac sympathetic nerves at the cellular level.
In the trial, 964 patients with New York Heart Association (NYHA) class II (83%) and III (17%) heart failure (66% ischemic, 34% nonischemic) and left ventricular ejection fraction of 35% or less (mean, 27.1%; median, 29%) underwent early (15-minute) and late (four-hour) planar and SPECT myocardial imaging.
After some patients were excluded, the researchers were left with a population of 961 individuals who were observed every six to seven weeks over the course of two years to monitor for the occurrence of cardiac events. During the median follow-up period of 17 months, first cardiac events were observed in 237 patients (25%), which included 163 cases of heart failure progression, 50 arrhythmic events, and 24 cardiac deaths.
The risk of cardiac events was significantly lower for patients with a heart/mediastinum (H/M) ratio of 1.60 or greater, with a hazard ratio of 0.40 (97.5% confidence interval: 0.25 to 0.64; p < 0.001).
Survival analysis revealed two-year event rates of 15% for patients with an H/M of 1.60 or greater, compared with 38% for patients whose H/M was less than 1.60.
Related Reading
GE partners with CardioDx on diagnostics, May 13, 2010
GE's German IT unit chooses Matrox boards, May 12, 2010
GE begins 1st Optima MR450w installs, April 28, 2010
GE, Nycomed extend partnership, April 28, 2010
GE targets ultrasound energy reduction, April 26, 2010
Copyright © 2010 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnieeurope.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
