Creation of mortality risk charts using 123I meta-iodobenzylguanidine heart-to-mediastinum ratio in patients with heart failure: 2- and 5-year risk models.
Creation of mortality risk charts using 123I meta-iodobenzylguanidine heart-to-mediastinum ratio in patients with heart failure: 2- and 5-year risk models.
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DOI：
10.1093/ehjci/jev322
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发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Jacobson AF
中科院分区：
文献类型：
--
作者：
Nakajima K;Nakata T;Matsuo S;Jacobson AF
123 I间碘苄胍（MIBG）显像已被广泛用于慢性心力衰竭（CHF）患者的心脏检查。本研究的目的是建立短期（2年）和长期（5年）预测心源性死亡率的死亡风险图表。使用1322例CHF患者的汇总数据库，进行多变量分析，包括123 I-MIBG晚期心脏-纵隔比率（HMR）、左心室射血分数（LVEF）和临床因素，以确定使用患者亚组（分别为1280和933例）预测2年和5年死亡风险的最佳变量。进行多变量逻辑回归分析以创建风险图。2年和5年分析亚群的心源性死亡率分别为10%和22%。采用四参数多变量logistic回归模型，包括年龄、纽约心脏协会（NYHA）心功能分级、LVEF和HMR。无论年龄和LVEF如何，NYHA I-II级且HMR ≥ 2.0的患者的年死亡率<1%。在NYHA III-IV级患者中，在所有LVEF分级中，HMR < 1.40的死亡率是HMR ≥ 2.0的4-6倍。在具有B型利钠肽（BNP）结果的患者亚组中（2年和5年模型分别为n = 491和359），5年模型显示除BNP外，HMR值也增加。123 I-MIBG HMR的2年和5年风险预测模型均可用于识别低风险和高风险患者，即使BNP可用，也可有效用于CHF患者的进一步风险分层。
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. 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. 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.
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影响因子：
37.8
作者：
Mozaffarian, Dariush;Anker, Stefan D.;Levy, Wayne C.
通讯作者：
Levy, Wayne C.
DOI：
10.1007/s00259-007-0639-3
发表时间：
2008-03-01
影响因子：
9.1
作者：
Agostini, Denis;Verberne, Hein J.;Jacobson, Arnold F.
通讯作者：
Jacobson, Arnold F.
DOI：
10.1007/s00259-014-2754-2
发表时间：
2014-09-01
影响因子：
9.1
作者：
Kasama, Shu;Toyama, Takuji;Kurabayashi, Masahiko
通讯作者：
Kurabayashi, Masahiko
DOI：
10.1007/s00259-014-2759-x
发表时间：
2014-09-01
影响因子：
9.1
作者：
Nakajima, Kenichi;Nakata, Tomoaki;Jacobson, Arnold F.
通讯作者：
Jacobson, Arnold F.
影响因子：
2.4
作者：
Nakajima, Kenichi;Okuda, Koichi;Yoshimura, Mana;Matsuo, Shinro;Wakabayashi, Hiroshi;Imanishi, Yasuhiro;Kinuya, Seigo
通讯作者：
Kinuya, Seigo