Abstract
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Introduction: To evaluate the prognostic significance of brain metabolism in patients with ischemic heart failure (IHF).
Methods: Consecutive IHF patients [age 58.0 (IQR 50.0- 64.0) years] were prospectively enrolled and were performed by gated single photon emission computed tomography/computed tomography (SPECT/CT) myocardial perfusion imaging (MPI) and cerebral PET/CT imaging. Independent predictors of all-cause death were assessed with by Cox analysis. The survival curve was analyzed by Kaplan-Meier method.
Results: Thirty-eight (19.3%) had all-cause death during a median follow-up of 3.3 years. Glucose metabolism in the left orbital middle frontal gyrus, orbital inferior frontal gyrus, olfactory cortex, insula, anterior cingulate and paracingulate gyri, hippocampus, amygdala, lingual gyrus and caudate nucleus were independent predictors for all-cause death in IHF patients, respectively (all P < 0.05). Patients were divided into three groups according to tertiles of the left hippocampal metabolism, the cumulative survival in the hypermetabolic group was significantly higher than that in the hypometabolic group (89 ± 4% vs. 65 ± 8%, P = 0.042). Notably, glucose metabolism in the left hippocampus (P = 0.008) or the left amygdala (P = 0.037) was associated with all-cause death in patients with New York Heart Association (NYHA) III-IV class, but not in patients with NYHA I-II class.
Conclusions: Brain hypometabolism was associated with all-cause death, and it may suggest that cerebral hypometabolism can be used as a marker of clinical prognosis in patients with IHF.
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