{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:43:46Z","timestamp":1771922626569,"version":"3.50.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1765,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In patients with heart failure, over-activation of the cardiac sympathetic nerve (CSN) function is associated with severity of heart failure and worse outcome. The effects of MitraClip therapy on the CSN activity in patients with mitral regurgitation (MR) remained unknown. In this study, we evaluated the impact of the MitraClip therapy on CSN activity assessed by 123I-metaiodobezylguanidine (MIBG) scintigraphy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We enrolled consecutive patients with moderate-to-severe (3+) or severe (4+) MR who were scheduled to undergo MitraClip procedure in this prospective observational study. MIBG scintigraphy was performed at baseline and 6 months after the MitraClip procedure to evaluate the heart\u2013mediastinum ratio and washout rate (WR). Changes in these MIBG parameters were analysed. Of the 13 consecutive patients, 10 were successfully treated with MitraClip procedure and completed follow-up assessment. With regard to the MIBG parameters, changes in the early and delayed heart\u2013mediastinum ratio from baseline to 6 months were not significant (2.16 \u00b1 0.42 to 2.06 \u00b1 0.34, P = 0.38 and 1.87 \u00b1 0.39 to 1.83 \u00b1 0.39, P = 0.43, respectively), whereas WR was significantly decreased (38.6 \u00b1 3.9% to 32.6 \u00b1 3.94%, P = 0.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CSN activity of the WR on MIBG imaging was improved 6 months after MitraClip therapy in patients with 3+ or 4+ MR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13266","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T22:10:15Z","timestamp":1613859015000},"page":"1590-1595","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Changes in Cardiac Sympathetic Nerve Activity on 123I-Metaiodobenzylguanidine Scintigraphy After MitraClip Therapy"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0309-7445","authenticated-orcid":false,"given":"Keisuke","family":"Fukuda","sequence":"first","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiji","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonori","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoto","family":"Waratani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kumiko","family":"Hirata","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522 ,","place":["Japan"]},{"name":"Department of Medical Science, Osaka Educational University , Osaka ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Higashimori","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Yokoi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"2026012115075392000_ehf213266-bib-0001","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jcmg.2009.07.014","article-title":"Cardiac sympathetic imaging with mIBG in heart failure","volume":"3","author":"Carri\u00f3","year":"2010","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026012115075392000_ehf213266-bib-0002","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.jcmg.2012.02.019","article-title":"Influence of ejection fraction on the prognostic value of sympathetic innervation imaging with iodine-123 MIBG in heart failure","volume":"5","author":"Shah","year":"2012","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026012115075392000_ehf213266-bib-0003","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1067\/mnc.2002.121471","article-title":"MIBG imaging","volume":"9","author":"Patel","year":"2002","journal-title":"J Nucl Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0004","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1093\/eurheartj\/ehn113","article-title":"Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: a systematic review","volume":"29","author":"Verberne","year":"2008","journal-title":"Eur Heart J"},{"key":"2026012115075392000_ehf213266-bib-0005","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1016\/j.jacc.2010.01.014","article-title":"Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure. Results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study","volume":"55","author":"Jacobson","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0006","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.jcmg.2013.02.007","article-title":"A pooled analysis of multicenter cohort studies of 123I-mIBG imaging of sympathetic innervation for assessment of long-term prognosis in heart failure","volume":"6","author":"Nakata","year":"2013","journal-title":"JACC Cardiovasc Imaging"},{"key":"2026012115075392000_ehf213266-bib-0007","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s00259-004-1624-8","article-title":"Cardiac metaiodobenzylguanidine activity can predict the long-term efficacy of angiotensin-converting enzyme inhibitors and\/or beta-adrenoceptor blockers in patients with heart failure","volume":"32","author":"Nakata","year":"2005","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2026012115075392000_ehf213266-bib-0008","first-page":"1279","article-title":"Spironolactone improves cardiac sympathetic nerve activity and symptoms in patients with congestive heart failure","volume":"43","author":"Kasama","year":"2002","journal-title":"J Nucl Med"},{"key":"2026012115075392000_ehf213266-bib-0009","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/j.1540-8159.2005.09508.x","article-title":"Cardiac resynchronization induces favorable neurohumoral changes","volume":"28","author":"Erol-Yilmaz","year":"2005","journal-title":"Pacing Clin Electrophysiol"},{"key":"2026012115075392000_ehf213266-bib-0010","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.nuclcard.2007.08.004","article-title":"Cardiac sympathetic activity pre and post resynchronization therapy evaluated by 123I-MIBG myocardial scintigraphy","volume":"14","author":"Nishioka","year":"2007","journal-title":"J Nucl Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0011","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ijcard.2016.01.131","article-title":"123I-mIBG imaging predicts functional improvement and clinical outcome in patients with heart failure and CRT implantation","volume":"207","author":"Curcio","year":"2016","journal-title":"Int J Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0012","doi-asserted-by":"crossref","first-page":"2844","DOI":"10.1016\/j.jacc.2015.10.018","article-title":"Randomized comparison of percutaneous repair and surgery for mitral regurgitation: 5-year results of EVEREST II","volume":"66","author":"Feldman","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0013","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1056\/NEJMoa1806640","article-title":"Transcatheter mitral-valve repair in patients with heart failure","volume":"379","author":"Stone","year":"2018","journal-title":"N Engl J Med"},{"key":"2026012115075392000_ehf213266-bib-0014","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1161\/CIRCIMAGING.112.000098","article-title":"Percutaneous mitral valve repair in the initial EVEREST cohort: evidence of reverse left ventricular remodeling","volume":"6","author":"Foster","year":"2013","journal-title":"Circ Cardiovasc Imaging"},{"key":"2026012115075392000_ehf213266-bib-0015","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jacc.2013.10.021","article-title":"Improved functional status and quality of life in prohibitive surgical risk patients with degenerative mitral regurgitation after transcatheter mitral valve repair","volume":"64","author":"Lim","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0016","first-page":"475","article-title":"Hemodynamic improvement at three months after MitraClip\u00c2\u00ae treatment in end-stage heart failure patients with functional mitral regurgitation","volume":"25","author":"Barth","year":"2016","journal-title":"J Heart Valve Dis"},{"key":"2026012115075392000_ehf213266-bib-0017","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.ijcard.2016.12.190","article-title":"Immediate increase of cardiac output after percutaneous mitral valve repair (PMVR) determined by echocardiographic and invasive parameters: Patzelt: increase of cardiac output after PMVR","volume":"236","author":"Patzelt","year":"2017","journal-title":"Int J Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0018","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1536\/ihj.16-255","article-title":"Role of right ventricular dysfunction and diabetes mellitus in N-terminal pro-B-type natriuretic peptide response of patients with severe mitral regurgitation and heart failure after MitraClip","volume":"58","author":"Kaneko","year":"2017","journal-title":"Int Heart J"},{"key":"2026012115075392000_ehf213266-bib-0019","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/j.amjcard.2018.06.031","article-title":"Changes in left atrial function after transcutaneous mitral valve repair","volume":"122","author":"Avenatti","year":"2018","journal-title":"Am J Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0020","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.jacc.2009.03.077","article-title":"Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort","volume":"54","author":"Feldman","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0021","first-page":"1326","article-title":"Pharmacological interference with 123I-metaiodobenzylguanidine: a limitation to developing cardiac innervation imaging in clinical practice?","volume":"17","author":"Stefanelli","year":"2013","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2026012115075392000_ehf213266-bib-0022","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s12350-010-9313-4","article-title":"Semi-automated algorithm for calculating heart-to-mediastinum ratio in cardiac iodine-123 MIBG imaging","volume":"18","author":"Okuda","year":"2011","journal-title":"J Nucl Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2026012115075392000_ehf213266-bib-0024","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/S0894-7317(03)00335-3","article-title":"Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography","volume":"16","author":"Zoghbi","year":"2003","journal-title":"J Am Soc Echocardiogr"},{"key":"2026012115075392000_ehf213266-bib-0025","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1016\/0735-1097(95)00374-6","article-title":"Iodine-123 metaiodobenzylguanidine images reflect intense myocardial adrenergic nervous activity in congestive heart failure independent of underlying cause","volume":"26","author":"Imamura","year":"1995","journal-title":"J Am Coll Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0026","first-page":"14","article-title":"Abnormalities of cardiac sympathetic neuronal and left ventricular function in chronic mitral regurgitation: assessment by iodine-123 metaiodobenzylguanidine scintigraphy","volume":"10","author":"Tsutsui","year":"1996","journal-title":"Am J Card Imaging"},{"key":"2026012115075392000_ehf213266-bib-0027","first-page":"187","article-title":"Evaluation of myocardial sympathetic nerve function in patients with mitral valve prolapse using iodine-123-metaiodobenzylguanidine myocardial scintigraphy","volume":"35","author":"Kishi","year":"2004","journal-title":"J Med"},{"key":"2026012115075392000_ehf213266-bib-0028","doi-asserted-by":"crossref","first-page":"H8788","DOI":"10.1152\/ajpheart.00007.2003","article-title":"Cardiac-specific norepinephrine mass transport and its relationship to left ventricular size and systolic performance","volume":"287","author":"Grossman","year":"2004","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2026012115075392000_ehf213266-bib-0029","first-page":"247","article-title":"Clinical evaluation of 123I-metaiodobenzylguanidine myocardial scintigram in patients with valvular heart disease","volume":"25","author":"Terada","year":"1995","journal-title":"J Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0030","doi-asserted-by":"crossref","first-page":"2969","DOI":"10.1016\/j.jacc.2019.09.017","article-title":"Echocardiographic outcomes after transcatheter leaflet approximation in patients with secondary mitral regurgitation: the COAPT trial","volume":"74","author":"Asch","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026012115075392000_ehf213266-bib-0031","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jtcvs.2007.10.067","article-title":"Determinants of early decline in ejection fraction after surgical correction of mitral regurgitation","volume":"136","author":"Suri","year":"2008","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026012115075392000_ehf213266-bib-0032","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1136\/hrt.76.3.218","article-title":"Increased myocardial [123I]-metaiodobenzylguanidine uptake after enalapril treatment in patients with chronic heart failure","volume":"76","author":"Somsen","year":"1996","journal-title":"Heart"},{"key":"2026012115075392000_ehf213266-bib-0033","first-page":"1796","article-title":"Effects of carvedilol on myocardial sympathetic innervation in patients with chronic heart failure","volume":"46","author":"Cohen-Solal","year":"2005","journal-title":"J Nucl Med"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13266","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13266","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/2\/1590\/65926632\/eschf_8_2_1590.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/2\/1590\/65926632\/eschf_8_2_1590.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T20:09:48Z","timestamp":1769026188000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/8\/2\/1590\/8381889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,19]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,19]]},"published-print":{"date-parts":[[2021,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13266","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4]]},"published":{"date-parts":[[2021,2,19]]},"assertion":[{"value":"2020-11-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}