Abstract 3789: Cardiac I-123 Metaiodobenzylguanidine Imaging Provides Additional Prognostic Power to Seattle Heart Failure Model in Patients With Chronic Heart Failure: A 10-year Follow-up Comparative Study
Background: The Seattle Heart Failure Model (SHFM) is a validated prediction model that estimates the mortality in chronic heart failure (CHF) by using commonly obtained clinical, laboratory, medication, and device variables. On the other hand, cardiac I-123 metaiodobenzylguanidine (MIBG) imaging also provides prognostic information in CHF patients. However, it remains unclear whether cardiac MIBG imaging would have the additional prognostic power to SHFM in patients with CHF.
Methods: We studied 106 CHF outpatients with radionuclide left ventricular ejection fraction (LVEF)< 40% (30±8%), and the SHFM score (SHFS) was obtained at the enrollment. Cardiac MIBG washout rate (WR) was calculated from the chest anterior view images obtained at 20 and 200 min after isotope injection. Abnormal WR was defined as WR>27% reported previously. They were followed up for >10 years.
Result: With a mean follow-up of 6.8±3.5 (0 –13) years, 32 of 106 patients had cardiac death. At univariate Cox analysis, WR (p<0.0001), SHFS (p=0.0009) and LVEF (p=0.006) were significantly independently associated with cardiac death. At multivariate Cox analysis, WR (p=0.0003) and SHFS (p=0.02) were significantly independently associated with cardiac death. Kaplan-Meier analysis revealed that patients with abnormal WR had a significantly higher risk of cardiac death than those with normal WR in patients both with SHFS≥1 (67% (12/18) vs 20% (3/15), p=0.01, RR: 3.3) and with SHFS≤0 (37% (13/35) vs 11% (4/38), p=0.004, RR: 3.4).
Conclusion: Cardiac MIBG WR would provide additional prognostic information to SHFM score in CHF patients.