Abstract 12250: Prediction of Patients With Chronic Heart Failure at Risk for Sudden Cardiac Death by Combination of Cardiac I-123 Metaiodobenzylguanidine Imaging and Long Runs of Non-Sustained Ventricular Tachycardia:a Serial Evaluation Study
Background: Identification of patients (pts) with chronic heart failure (CHF) at risk for sudden cardiac death (SCD) is an important objective. Cardiac I-123 metaiodobenzylguanidine (MIBG) imaging provides prognostic information in pts with CHF. On the other hand, long runs of non-sustained ventricular tachycardia (high-grade NSVT) has been associated with an increased risk of SCD in pts with coronary artery disease. However, there is little information available on the comparison of the prognostic significance for SCD between MIBG and high grade-NSVT in patients with CHF.
Methods and Results: We studied 105 consecutive outpatients (NYHA class: 2.1±0.6), with LVEF 27%.High-grade NSVT was defined as consecutive 6 or more beats and more than 100 bpm. All pts underwent 24-hour ECG Holter monitoring and MIBG at the entry and every year after entry for three years. In the serial Holter monitoring, 32 pts had high-grade NSVT. At the last evaluation of MIBG study, 51 pts had abnormal WR. During the mean follow-up period of 5.1±3.5 years, 22 pts had SCD. A multivariate Cox analysis revealed that both abnormal WR and high-grade NSVT were significantly and independently associated with SCD (abnormal WR; hazard ratio 3.4 [95%CI 1.2-10.0], p = 0.025, high-grade NSVT; hazard ratio 3.3[95%Cl 1.3-8.2], p = 0.012). Pts with both abnormal WR and high-grade NSVT and those with either abnormal WR or high-grade NSVT had a significantly higher SCD risk than those with none of these parameters (47 [9/47] % vs 29 [13/45] % vs 0 [0/41] %, p<0.0001).
Conclusion: The combination of abnormal WR and high-grade NSVT would be more strongly associated with an increased risk of SCD in CHF pts.
Author Disclosures: M. Ishimi: None. T. Yamada: None. T. Morita: None. Y. Furukawa: None. S. Tamaki: None. Y. Iwasaki: None. M. Kawasaki: None. A. Kikuchi: None. T. Kondo: None. M. Fukunami: None.
- © 2015 by American Heart Association, Inc.