Abstract 13703: Combination of Iodine-123-Metaiodobenzylguanidine Imaging and Heart-Type Fatty Acid Binding Protein for Risk Stratification in Heart Failure with Preserved Ejection Fraction

Abstract

Background: Recently, we and several investigators have shown that iodine-123-metaiodobenzylguanidine (123I-MIBG) imaging was a useful tool for evaluating severity of heart failure with preserved ejection fraction (HFPEF) and predicting future cardiac events. Heart-type fatty acid binding protein (H-FABP) has been used as a marker of ongoing myocardial damage. The prognostic value of combination of 123I-MIBG imaging and H-FABP in HFPEF is unknown.

Methods and Results: We performed 123I-MIBG scintigraphy, echocardiography and measured H-FABP levels of consecutive 97 HFPEF patients with LVEF >50% (53 men, mean age 66±15 years) who admitted to our hospital in this study. Patients were prospectively followed with endpoints of cardiac death or rehospitalization. Patients were divided into 2 groups by 123I-MIBG washout rate (WR). Kaplan-Meier analysis revealed that cardiac event rate was significantly higher in high 123I-MIBG WR group (43%) than in low 123I-MIBG WR group (19%) (p<0.05). Moreover, if patients were divided into 4 groups by 123I-MIBG WR and H-FABP, cardiac event rate was 2.9-fold increase in high 123I-MIBG WR and high H-FABP group (56%) compared to low 123I-MIBG WR and low-H-FABP group (12%) (p<0.05).

Conclusion: The combination of 123I-MIBG imaging and H-FABP could potentially improve the risk stratification in patients with HFPEF.