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European Journal of Nuclear Medicine and Molecular Imaging

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01-05-2022 | Heart Failure | Original Article

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

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

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 6/2022

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.

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Title: Usefulness of the 2-year iodine-123 metaiodobenzylguanidine-based risk model for post-discharge risk stratification of patients with acute decompensated heart failure
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
Publication date: 01-05-2022
Publisher: Springer Berlin Heidelberg
Keyword: Heart Failure
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 6/2022
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-021-05663-y

At a glance: The STEP trials

Springer Medicine

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

Methods

Results

Conclusion

Trial registration number

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration number

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