+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Selective improvement in Seattle Heart Failure Model risk stratification using iodine-123 meta-iodobenzylguanidine imaging



Selective improvement in Seattle Heart Failure Model risk stratification using iodine-123 meta-iodobenzylguanidine imaging



Journal of Nuclear Cardiology 19(5): 1007-1016



The Seattle Heart Failure Model (SHFM) is a multivariable model that uses demographic and clinical markers to predict survival in patients with heart failure. Inappropriate activation of the sympathetic nervous system, which contributes to the progression of heart failure and increased mortality, can be assessed using iodine-123 meta-iodobenzylguanidine (MIBG) cardiac imaging. This study investigated the incremental value of MIBG cardiac imaging when added to the SHFM for prediction of all-cause mortality. Survival data from 961 NYHA II-III subjects in the ADMIRE-HFX trial were included in this analysis. The predictive value of the SHFM alone and in combination with MIBG heart-to-mediastinum ratio (H/M) was compared for all-cause mortality (101 deaths during a median follow-up of 2 years). The addition of H/M to the SHFM in a Cox model significantly improved risk prediction (P < .0001), with a greater utility in higher risk SHFM patients. The observed 2-year mortality in the highest-risk SHFM subjects (rounded SHFM score of 1) was 24%, but varied from 46% with H/M <1.2 to 0% with H/M >1.8. Net reclassification improvement was 22.7% (P < .001), with 14.9% of subjects who died reclassified into a higher risk category than suggested by SHFM score alone (P = .01) and 7.9% of subjects who survived reclassified into a lower risk category (P < .0001). The 2-year integrated discrimination improvement (+4.14%, P < .0001) and the 1-year area under the receiver-operator characteristic curve (+0.04, P = .026) both showed significant improvement for the combined model with H/M compared to the SHFM alone. The addition of MIBG imaging to the SHFM improves risk stratification, especially in higher risk patients. MIBG may have clinical utility in higher risk patients who are being considered for devices such as ICD, CRT-D, LVAD, and cardiac transplantation.

(PDF emailed within 0-6 h: $19.90)

Accession: 036572805

Download citation: RISBibTeXText

PMID: 22949270

DOI: 10.1007/s12350-012-9603-0


Related references

Usefulness of cardiac iodine-123 meta-iodobenzylguanidine imaging to improve prognostic power of Seattle heart failure model in patients with chronic heart failure. American Journal of Cardiology 107(8): 1185-1190, 2011

Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure. Results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study. Journal of the American College of Cardiology 55(20): 2212-2221, 2010

Incremental utility of iodine-123 meta-iodobenzylguanidine imaging beyond established heart failure risk models. Journal of Cardiac Failure 20(8): 577-583, 2015

Renal dysfunction does not affect the prognostic value of myocardial iodine-123 meta-iodobenzylguanidine imaging in heart failure. Nuclear Medicine Communications 35(1): 58-63, 2014

Timely access to care - Risk stratification utilizing the Seattle heart failure model in patients with advanced heart failure: Dying to be seen. 2007

Prognosis of congestive heart failure chf evaluated by iodine 123 labeled meta iodobenzylguanidine mibg myocardial imaging. Journal of the American College of Cardiology 13(2 SUPPL A): 180A, 1989

From statistical significance to clinical relevance: A simple algorithm to integrate brain natriuretic peptide and the Seattle Heart Failure Model for risk stratification in heart failure. Journal of Heart and Lung Transplantation 35(6): 714-721, 2018

Cost-Effectiveness Analysis of Iodine-123 Meta-Iodobenzylguanidine Imaging for Screening Heart Failure Patients Eligible for an Implantable Cardioverter Defibrillator in the USA. Applied Health Economics and Health Policy 14(3): 361-373, 2017

Clinical usefulness of myocardial innervation imaging using Iodine-123-meta-iodobenzylguanidine scintigraphy in evaluating the effectiveness of pharmacological treatments in patients with heart failure: an overview. European Review for Medical and Pharmacological Sciences 17(1): 56-68, 2013

Can cardiac iodine-123 metaiodobenzylguanidine imaging contribute to risk stratification in heart failure patients?. European Journal of Nuclear Medicine and Molecular Imaging 35(3): 532-534, 2008

Utility of the Seattle heart failure model in stratification of heart failure patients for ventricular assist device therapy. Asaio Journal 58(2): 91-92, 2012

Timely access to care - The seattle heart failure survival score in risk stratification at the time of referral of patients with advanced heart failure: Dying to be seen. Canadian Journal of Cardiology 23(Suppl. C): 151C, 2007

Creation of mortality risk charts using 123I meta-iodobenzylguanidine heart-to-mediastinum ratio in patients with heart failure: 2- and 5-year risk models. European Heart Journal Cardiovascular Imaging 17(10): 1138-1145, 2017

Usefulness of cardiac meta-iodobenzylguanidine imaging to identify patients with chronic heart failure and left ventricular ejection fraction <35% at low risk for sudden cardiac death. American Journal of Cardiology 115(11): 1549-1554, 2015

Risk stratification of patients with chronic heart failure using cardiac iodine-123 metaiodobenzylguanidine imaging: incremental prognostic value over right ventricular ejection fraction. Esc Heart Failure 2(4): 116-121, 2016