TY - JOUR T1 - Prognostic Value of <sup>123</sup>I-BMIPP SPECT in Patients with Nonischemic Heart Failure with Preserved Ejection Fraction JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 259 LP - 265 DO - 10.2967/jnumed.117.195743 VL - 59 IS - 2 AU - Hidenobu Hashimoto AU - Rine Nakanishi AU - Sunao Mizumura AU - Yukiko Hashimoto AU - Yuriko Okamura AU - Shunsuke Kiuchi AU - Junichi Yamazaki AU - Takanori Ikeda Y1 - 2018/02/01 UR - http://jnm.snmjournals.org/content/59/2/259.abstract N2 - Imaging of myocardial fatty acid metabolism using 123I-betamethyl-p-iodophenyl-pentadecanoic acid (123I-BMIPP) SPECT is useful for identifying high-risk patients with known ischemic heart disease. However, its utility for patients who have nonischemic heart failure with preserved ejection fraction is not well known. This study aimed to evaluate the prognostic value of the 123I-BMIPP defect score in such patients. Methods: Of 804 consecutive patients who were admitted to the hospital because of acute heart failure and underwent 123I-BMIPP SPECT, we identified 133 (mean age ± SD, 73 ± 13 y) who had normal coronary arteries by invasive coronary angiography and preserved left ventricular ejection fraction (≥50%) by echocardiography. 123I-BMIPP defects were quantitatively scored to obtain summed defect scores in 17 segments of 123I-BMIPP SPECT images. The patients were divided into 2 groups based on their score. The multivariate Cox model was used to assess a possible correlation between a higher score (≥4, n = 46) and major adverse cardiac events, including cardiac death, cardiovascular events, and hospitalization for heart failure, compared with a lower score (&lt;4, n = 87). Results: During a mean follow-up of 2.5 y, 35 major adverse cardiac events occurred. The median scores in the high-score and low-score groups were 7.13 ± 4.21 and 1.29 ± 0.80, respectively. By multivariate Cox analysis, a higher score was associated with increased major adverse cardiac events, compared with a lower score (hazard ratio, 11.04; 95% confidence interval, 4.93–24.74; P &lt; 0.001). Conclusion: This study demonstrated that the defect score by 123I-BMIPP SPECT may have potential prognostic value in patients who have nonischemic heart failure with preserved ejection fraction. ER -