A wall based regional innervation/perfusion mismatch assessed by cardiac 123I-mIBG and rest 99mTc-tetrofosmin SPECT to predict arrhythmic events in ischemic heart failure patients

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac 123I-mIBG SPECT imaging provides information on regional myocardial innervation. However, there is no consensus how to use a, 17-segment based score assess prognosis. The present study examined whether a simpler scoring approach for evaluation combined with rest 99mTc-tetrofosmin perfusion could be used the prediction arrhythmic events (AEs) in ischemic heart failure (HF). Methods 261 HF subjects (NYHA II/III, LVEF ?35% gated SPECT) ADMIRE-HF cohort complete cardiac and studies were enrolled. Both image sets read together by 2 experienced nuclear imagers scored consensus. In addition standard 17 segments scoring, readers classified walls (i.e. anterior, lateral, inferior, septum apex) as normal, matched defect innervation perfusion, mismatched (i.e., lager than defect) or reverse smaller defect). Cox proportional hazards ratios (HR) determine if visual segmental wall classification innervation/perfusion mismatch score, summed scores (SDS), SDS SDS, age, LVEF, NYHA class, B-type natriuretic peptide (BNP) norepinephrine (NE) plasma levels associated occurrence AEs sudden death, sustained VT, resuscitated arrest, appropriate ICD therapy). Results At 2-year median follow-up, 38 (14.6%) had AEs. Subjects 1 more twice likely have compared either 0 3-5 (24.0% vs 10.8%, p = 0.006). regression analyses showed that combination presence 1-2 BNP only independent predictors (HR 2.583 [1.261-5.107],p 0.001) mismatch, contribution relatively small HR 1.001 [1.000-1.001]). Conclusion ?35 highest risk occurs intermediate wall-level mismatches. Therefore, simple assessment can differentiate those patients at higher AE from low risk. Table 1. analysis Variable (95% CI) X2 change p-value AE’s 2.412 (1.204-4.830) 6.581 5.880 0.010 (1.000-1.001) 2.538 (1.261-5.107) 13.434 4.129 0.001 Figure. Kaplan Meier curves