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- Title
Creation of mortality risk charts using <sup>123</sup>I meta-iodobenzylguanidine heart-to-mediastinum ratio in patients with heart failure: 2- and 5-year risk models.
- Authors
Kenichi Nakajima; Tomoaki Nakata; Shinro Matsuo; Arnold F. Jacobson
- Abstract
Aims 123I meta-iodobenzylguanidine (MIBG) imaging has been extensively used for prognostication in patients with chronic heart failure (CHF). The purpose of this study was to create mortality risk charts for short-term (2 years) and long-term (5 years) prediction of cardiac mortality.Methods and results Using a pooled database of 1322 CHF patients, multivariate analysis, including 123I-MIBG late heart-to-mediastinum ratio (HMR), left ventricular ejection fraction (LVEF), and clinical factors, was performed to determine optimal variables for the prediction of 2- and 5-year mortality risk using subsets of the patients (n = 1280 and 933, respectively). Multivariate logistic regression analysis was performed to create risk charts. Cardiac mortality was 10 and 22% for the sub-population of 2- and 5-year analyses. A four-parameter multivariate logistic regression model including age, New York Heart Association (NYHA) functional class, LVEF, and HMR was used. Annualized mortality rate was <1% in patients with NYHA Class I–II and HMR ≥ 2.0, irrespective of age and LVEF. In patients with NYHA Class III–IV, mortality rate was 4–6 times higher for HMR < 1.40 compared with HMR ≥ 2.0 in all LVEF classes. Among the subset of patients with b-type natriuretic peptide (BNP) results (n = 491 and 359 for 2- and 5-year models, respectively), the 5-year model showed incremental value of HMR in addition to BNP.Conclusion Both 2- and 5-year risk prediction models with 123I-MIBG HMR can be used to identify low-risk as well as high-risk patients, which can be effective for further risk stratification of CHF patients even when BNP is available.
- Publication
European Heart Journal - Cardiovascular Imaging, 2016, Vol 17, Issue 10, p1138
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jev322