Prediction of sudden death in patients with mild-to-moderate chronic heart failure by using cardiac iodine-123 metaiodobenzylguanidine imaging
Prediction of sudden death in patients with mild-to-moderate chronic heart failure by using cardiac iodine-123 metaiodobenzylguanidine imaging
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DOI：
10.1136/hrt.2006.094524
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发表时间：
2007-10-01
期刊：
影响因子：
5.7
通讯作者：
Fukunami, Masatake
中科院分区：
文献类型：
--
作者：
Kioka, Hidetaka;Yamada, Takahisa;Fukunami, Masatake
目的：目的：评价心脏碘-123（I-123）间碘苄胍（MIBG）显像作为慢性心力衰竭（CHF）患者猝死预测指标的有效性。设计和背景：三级转诊中心的前瞻性队列研究。患者：97例CHF门诊患者，放射性核素左心室射血分数< 40%。干预：在研究开始时，进行心脏I-123 MIBG成像。通过MIBG显像获得心脏MIBG心-胃比值（H/M）和洗脱率（WR）。主要结果测量：根据27%的WR（对照组WR的平均值（2SD））将患者分为两组。97例CHF患者中48例WR异常（>= 27%），其余49例WR正常（< 27%）。结果：在平均65（29）个月的随访期内，WR异常组12例（25%）和WR正常组2例（4%）猝死。Kaplan-Meier分析显示，WR异常的患者比WR正常的患者更容易观察到猝死（p = 0.001）。经考克斯回归分析，MIBG WR、延迟显像H/M、早期显像H/M与猝死有显著相关性。结论：心脏MIBG显像对CHF患者猝死有预测价值。
Objective: To evaluate the usefulness of cardiac iodine-123 (I-123) metaiodobenzylguanidine ( MIBG) imaging as a predictor of sudden death in patients with chronic heart failure (CHF).Design and setting: Prospective cohort study in a tertiary referral centre.Patients: 97 outpatients with CHF with a radionuclide left ventricular ejection fraction < 40% ( mean (SD) 29% (7.5%)).Interventions: At study entry, cardiac I-123 MIBG imaging was performed. The cardiac MIBG heart-tomediastinum ratio (H/M) and washout rate (WR) were obtained from MIBG imaging. Main outcome measures: Patients were assigned to two groups based upon 27% of WR, which was the mean (2SD) control WR. 48 of 97 patients with CHF had abnormal WR (>= 27%), whereas the remaining 49 patients had normal WR (< 27%). All the study patients were then followed up.Results: During the mean ( SD) follow-up period of 65 ( 29) months, 12 (25%) patients in the abnormal WR group and 2 (4%) patients in the normal WR group died suddenly. Kaplan-Meier analysis revealed that sudden death was more often observed in patients with abnormal WR than those with normal WR ( p = 0.001). On Cox regression analysis, MIBG WR, H/M on the delayed image and H/ M on the early image were significantly associated with sudden death.Conclusion: Cardiac MIBG imaging would be useful for predicting sudden death in patients with CHF.