Usefulness of the 2-year iodine-123 metaiodobenzylguanidine-based risk model for post-discharge risk stratification of patients with acute decompensated heart failure.

Abstract

PURPOSE:

A four-parameter risk model that included cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging and readily available clinical parameters was recently developed for prediction of 2-year cardiac mortality risk in patients with chronic heart failure. We sought to validate the ability of this risk model to predict post-discharge clinical outcomes in patients with acute decompensated heart failure (ADHF) and to compare its prognostic value with that of the Acute Decompensated Heart Failure National Registry (ADHERE) and Get With The Guidelines-Heart Failure (GWTG-HF) risk scores.

METHODS:

We studied 407 consecutive patients who were admitted for ADHF and survived to discharge, with definitive 2-year outcomes (death or survival). Cardiac MIBG imaging was performed just before discharge. The 2-year cardiac mortality risk was calculated using four parameters, namely age, left ventricular ejection fraction, New York Heart Association functional class, and cardiac MIBG heart-to-mediastinum ratio on delayed images. Patients were stratified into three groups based on the 2-year cardiac mortality risk: low- (< 4%), intermediate- (4-12%), and high-risk (> 12%) groups. The ADHERE and GWTG-HF risk scores were also calculated.

RESULTS:

There was a significant difference in the incidence of cardiac death among the three groups stratified using the 2-year cardiac mortality risk model (p < 0.0001). The 2-year cardiac mortality risk model had a higher C-statistic (0.732) for the prediction of cardiac mortality than the ADHERE and GWTG-HF risk scores.

CONCLUSION:

The 2-year MIBG-based cardiac mortality risk model is useful for predicting post-discharge clinical outcomes in patients with ADHF.

TRIAL REGISTRATION NUMBER:

UMIN000015246, 25 September 2014.

• Authors: Shunsuke Tamaki, Takahisa Yamada, Tetsuya Watanabe, Takashi Morita, Masato Kawasaki, Atsushi Kikuchi, Tsutomu Kawai, Masahiro Seo, Jun Nakamura, Kiyomi Kayama, Daisuke Sakamoto, Kumpei Ueda, Takehiro Kogame, Yuto Tamura, Takeshi Fujita, Keisuke Nishigaki, Yuto Fukuda, Yuki Kokubu, Masatake Fukunami
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 49 Issue 6 Pg. 1906-1917 (05 2022) ISSN: 1619-7089 [Electronic] Germany
• PMID: 34997293 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Iodine Radioisotopes
• 3-Iodobenzylguanidine
• Iodine-123

Topics

• 3-Iodobenzylguanidine
• Aftercare
• Heart Failure (diagnostic imaging)
• Humans
• Iodine Radioisotopes
• Patient Discharge
• Prognosis
• Risk Assessment
• Stroke Volume
• Ventricular Function, Left