Body mass index and rest myocardial perfusion defect predicts cardiac death in patients with chronic heart failure.
Gated single photon emission computed tomography (SPECT) myocardial perfusion imaging has proven to be invaluable not only in assessing myocardial perfusion, but also in providing functional and volumetric information. The aim of this study was to investigate the value of clinical variables and rest gated SPECT myocardial perfusion imaging for predicting cardiac death in patients with chronic heart failure (CHF). Seventy-three consecutive hospitalized patients with CHF (aged 50.7 ± 16.5 years, 60 men and 13 women; 25 ischemic CHF and 48 non-ischemic CHF) and left ventricular ejection fraction on echocardiography <40%, who underwent rest gated SPECT myocardial perfusion imaging, were followed up for this study. Univariate and multivariate analysis of clinical characteristics and gated SPECT parameters for prediction of cardiac death were performed. During the follow-up period (18.6 ± 8.5 months), 14 (19.2%) cardiac deaths occurred. Multivariate Cox analysis showed that body mass index (BMI, 23.3 ± 4.1 kg/m(2), hazard ratio = 0.85, P = 0.025) and summed rest score (SRS, 11.8 ± 11.5, hazard ratio = 1.05, P = 0.021) were predictive for cardiac death. The optimal threshold of BMI was 25 kg/m(2) and patients with BMI < 25 kg/m(2) had lower survival rate (P = 0.013). The optimal threshold of SRS was set as 11 and patients with SRS > 11 had lower survival rate (P = 0.009). Rest gated SPECT myocardial perfusion imaging provides prognostic information in patients with CHF. BMI and SRS are both predictors of cardiac death in patients with CHF.
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Lu, Beijing100037, China.
Min
M
Cai
Feng
F
Wang
Jian
J
Zhang
Zuo-Xiang
ZX
He
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D016009:Chi-Square Distribution; D002681:China; D002908:Chronic Disease; D003326:Coronary Circulation; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D016277:Ventricular Function, Left