Abstract 13546: Cardiac I-123 Metaiodobenzylguanidine Imaging and Seattle Heart Failure Model Independently Predict Mode of Death in Patients With Chronic Heart Failure: A Long Term Follow up Comparative Study
Background: The Seattle Heart Failure Model (SHFM) is a validated prediction model for total mortality in chronic heart failure (CHF). In addition, cardiac MIBG imaging also provides prognostic information in CHF patients. Prediction of mode of death (sudden death (SD) or pump failure death (PFD)) may facilitate decisions about specific medications or devices. However, no information is available on the prognostic significance of the combination of MIBG imaging and SHFM, relating to mode of death in CHF patients.
Methods: We prospectively studied 106 CHF outpatients with left ventricular ejection fraction<40% (30±8%). Cardiac MIBG imaging was performed and the SHFM score (SHFS) was obtained at the enrollment. In cardiac MIBG imaging, MIBG washout rate (WR) was calculated, and abnormal WR was defined as WR>27%.
Results: During a mean follow-up of 6.8±3.5 (0–13) years, 20 patients had SD and 11 patients had PFD. Multivariate Cox analysis revealed that WR was the only independent predictor associated with SD (p=0.0018), although SHFS was significantly associated with SD at univariate analysis (p=0.036). As for PFD, at multivariate Cox analysis, SHFS was significantly associated with PFD (p=0.019), although WR tended to be associated with PFD (p=0.053). Kaplan-Meier analysis revealed that patients with abnormal WR and SHFS≥1 had significantly higher risk of SD and PFD compared to those with normal WR and SHFS≤0 (SD: 33% vs 8%, p=0.0079, HR 7.5 (1.8 to 30.8), PFD: 33% vs 3%, p<0.0001, HR 21.3 (2.6 to 178.4), respectively).
Conclusions: The combination of cardiac MIBG imaging and SHFM would improve the identification of higer risk subset in CHF patients, irrespective of mode of death.
- © 2010 by American Heart Association, Inc.