Abstract 14056: Prognostic Value of SmartMIBG-HF Risk Score in Patients With Preserved Left Ventricular Ejection Fraction Admitted for Acute Decompensated Heart Failure
Background: Cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging has been shown to provide prognostic information in patients with heart failure (HF) with preserved ejection fraction (HFpEF). On the other hand, smartMIBG-HF software, which has been recently generated from the database of chronic HF patients, is a useful computer application that evaluates the risk of 5-year cardiac mortality using baseline 5 parameters including NYHA class, age, gender, left ventricular ejection fraction (LVEF), and the late heart-to-mediastinum ratio obtained from cardiac MIBG imaging.
Purpose: We sought to elucidate whether the risk levels calculated by smartMIBG-HF software have predictive value even in HFpEF patients admitted for acute decompensated heart failure (ADHF).
Methods: We studied 104 consecutive patients admitted for ADHF and discharged with survival whose LVEF was ≧40% (age: 77±12 years, male: 50%, NYHA class at discharge: 2.1±0.8). Cardiac MIBG imaging and echocardiography were performed just before discharge, and we obtained smartMIBG-HF risk score by the software. The endpoints were unplanned hospitalization for worsening heart failure (WHF) and pump failure death (PFD).
Results: During a follow-up period of 2.0±0.8 years, 37 patients had WHF and 8 patients had PFD. At multivariate Cox analysis, out of the variables including clinical, hemodynamic, biochemical, MIBG, echocardiographic parameters and smartMIBG-HF risk score, smartMIBG-HF risk score was significantly independently associated with WHF (p<0.0001) and PFD (p=0.0004), although brain natriuretic peptide showed the significant association with WHF at univariate analysis. Receiver-operator curve analysis revealed that smartMIBG-HF score of 19% and 23% were fair discriminators for WHF (AUC 0.699 [95% CI 0.601-0.785], p=0.0004; sensitivity 62% and specificity 73%) and PFD (AUC 0.882 [95% CI 0.804-0.937], p<0.0001; sensitivity 100% and specificity 74%), respectively. Kaplan-Meier analysis showed that the patients with smartMIBG-HF score >19% and >23% had a significantly higher risk of WHF (p=0.0001) and PFD (p<0.0001), respectively.
Conclusions: SmartMIBG-HF risk score would be useful for the risk stratification even in HFpEF patients admitted for ADHF.
Author Disclosures: S. Tamaki: None. T. Yamada: None. T. Morita: None. Y. Furukawa: None. Y. Iwasaki: None. M. Kawasaki: None. A. Kikuchi: None. T. Kondo: None. T. Ozaki: None. Y. Sato: None. M. Seo: None. I. Ikeda: None. E. Fukuhara: None. M. Abe: None. J. Nakamura: None. M. Fukunami: None.
- © 2016 by American Heart Association, Inc.