Identical prognostic values of MIBG imaging in both ischemic and non-ischemic heart failure etiologies

Objectives Although there are several known prognostic determinants in heart failure, an individual risk profile could vary in particular between ischemic and non-ischemic backgrounds of heart failure. This study aimed to identify the difference in prognostic efficacies of cardiac 123I-meta-iodobenzylguanidine (MIBG) imaging between the two etiologies.

Methods All 1322 patients with heart failure were participants enrolled and followed up at most after ten years. The subjects of patients with heart failure were divided into two groups, ischemic group (n=362) and non-ischemic group (n=960), and Cox proportional hazards model was used for data analysis.

Results During ten years of follow-up, 296 (22.4%) of 1322 patients died; the mortality rates were 21.8% and 22.6% for the ischemic and non-ischemic groups, respectively. The ischemic group had greater prevalence of sudden death and lethal acute myocardial infarction, and the non-ischemic group had a higher rate of pump failure death. Multivariate Cox proportional hazards analysis using categorized variables demonstrated that in the ischemic group, delayed heart-to-mediastinum ratio (HMR) (p<0.0001), age (p=0.0002) and LVEF (p=0.03) were the independent significant predictors of lethal events. In the non-ischemic group, delayed HMR (p<0.0001), NYHA class (p<0.0001) and age (p<0.0001) significantly determined the lethal outcomes.

Conclusions Cardiac MIBG imaging has nearly identical prognostic values in both ischemic and non-ischemic heart failure etiologies, independently of causes of cardiac death.