{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:04:07Z","timestamp":1791201847755,"version":"4.2.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,7,16]]},"abstract":"<jats:sec id=\"jah39841-sec-0001\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:sup>123<\/jats:sup>\n              Iodine\u2010meta\u2010iodobenzylguanidine scintigraphy is useful for assessing cardiac autonomic dysfunction and predict outcomes in heart failure (HF). The relationship of cardiac sympathetic function with myocardial remodeling and diffuse fibrosis remains largely unknown. We aimed to evaluate the cardiac sympathetic function of patients with HF and its relation with myocardial remodeling and exercise capacity.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah39841-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Prospectively enrolled patients with HF (New York Heart Association class II\u2013III) were stratified into HF with preserved left ventricular ejection fraction [LVEF] \u226545%) and reduced LVEF. Ventricular morphology\/function and myocardial extracellular volume (ECV) fraction were quantified by cardiovascular magnetic resonance, global longitudinal strain by echocardiography, cardiac sympathetic function by heart\u2010to\u2010mediastinum ratio from\n              <jats:sup>123<\/jats:sup>\n              iodine\u2010meta\u2010iodobenzylguanidine scintigraphy. All participants underwent cardiopulmonary exercise testing. The cohort included 33 patients with HF with preserved LVEF (LVEF, 60\u00b110%; NT\u2010proBNP [N\u2010terminal pro\u2010B\u2010type natriuretic peptide], 248 [interquartile range, 79\u2013574]\u2009pg\/dL), 28 with HF with reduced LVEF (LVEF, 30\u00b19%; NT\u2010proBNP, 743 [interquartile range, 250\u20132054] pg\/dL) and 20 controls (LVEF, 65\u00b15%; NT\u2010proBNP, 40 [interquartile range, 19\u201350]\u2009pg\/dL). Delayed (4\u2009hours)\n              <jats:sup>123<\/jats:sup>\n              iodine\u2010meta\u2010iodobenzylguanidine heart\u2010to\u2010mediastinum ratio was lower in HF with preserved LVEF (1.59\u00b10.25) and HF with reduced LVEF (1.45\u00b10.16) versus controls (1.92\u00b10.24;\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001), and correlated negatively with diffuse fibrosis assessed by ECV (\n              <jats:italic toggle=\"no\">R<\/jats:italic>\n              =\u22120.34,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.01). ECV in segments without LGE was increased in HF with preserved ejection fraction (0.32\u00b10.05%) and HF with reduced left ventricular ejection fraction (0.31\u00b10.04%) versus controls (0.28\u00b10.04,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.05) and was associated with the age\u2010 and sex\u2010adjusted maximum oxygen consumption (peak oxygen consumption); (\n              <jats:italic toggle=\"no\">R<\/jats:italic>\n              =\u22120.41,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.01). Preliminary analysis indicates that cardiac sympathetic function might potentially act as a mediator in the association between ECV and NT\u2010proBNP levels.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah39841-sec-0003\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Abnormally low cardiac sympathetic function in patients with HF with reduced and preserved LVEF is associated with extracellular volume expansion and decreased cardiopulmonary functional capacity.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.035264","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T10:41:44Z","timestamp":1720003304000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8816-8830","authenticated-orcid":false,"given":"Luis M.","family":"da Silva","sequence":"first","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4161-8099","authenticated-orcid":false,"given":"Andr\u00e9a","family":"Coy\u2010Cangu\u00e7u","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7596-6668","authenticated-orcid":false,"given":"Layde R.","family":"Paim","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7010-3932","authenticated-orcid":false,"given":"Adriana A.","family":"Bau","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-4522","authenticated-orcid":false,"given":"Camila","family":"Nicolela Geraldo Martins","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5792-6598","authenticated-orcid":false,"given":"Stephan","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinicius","family":"Citeli 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Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5639-1325","authenticated-orcid":false,"given":"L\u00edgia","family":"Antunes\u2010Correa","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7127-2052","authenticated-orcid":false,"given":"Andrei","family":"Sposito","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0003-5102","authenticated-orcid":false,"suffix":"Jr","given":"Wilson","family":"Nadruz","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas","place":["S\u00e3o Paulo, 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