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Diagnostic value of parameters derived from planar MUGA for detecting HFpEF in coronary artery disease patients
Qiaozhi Liu1, Shuaishuai Zhou2, Qi Wu3
1Department of Cardiology, Zaozhuang Municipal Hospital, Zaozhuang, 277100, Shandong, China.
Insights
Planar gated blood-pool imaging (MUGA) can diagnose heart failure with preserved ejection fraction (HFpEF) in coronary artery disease patients. Combining peak filling rate (PFR) and peak filling time (TPF) from MUGA offers superior diagnostic value compared to echocardiography.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized in clinical practice.
- Coronary atherosclerotic heart disease (CAD) patients often present with complex cardiac conditions.
- Accurate diagnosis of HFpEF in CAD patients is crucial for effective management.
Purpose of the Study:
- To evaluate the diagnostic utility of diastolic function parameters derived from planar gated blood-pool imaging (MUGA) for detecting HFpEF.
- To compare the effectiveness of MUGA-derived parameters with standard echocardiographic assessments in HFpEF diagnosis.
- To identify optimal MUGA parameters for diagnosing HFpEF in patients with coronary artery disease.
Main Methods:
- Ninety-seven CAD patients with preserved ejection fraction (≥50%) were analyzed.
- Patients were categorized into HFpEF (LVEDP ≥ 16 mmHg) and normal diastolic function (LVEDP < 16 mmHg) groups.
- Diastolic function was assessed using MUGA parameters (PFR, 1/3FF, 1/3FR, MFR, TPF) and echocardiography (LAVI, peak TR velocity, E, e', E/e').
Main Results:
- MUGA parameters showed significant diagnostic capability for HFpEF.
- Peak filling rate (PFR) and peak filling time (TPF) from MUGA demonstrated high areas under the curve (AUCs 0.827 and 0.809, respectively).
- The combination of PFR and TPF yielded the highest AUC (0.856), outperforming individual echocardiographic parameters and their combination.
Conclusions:
- Diastolic function parameters obtained via planar MUGA are valuable for diagnosing HFpEF in CAD patients.
- The combined use of PFR and TPF from MUGA offers superior sensitivity and predictive power for HFpEF detection compared to echocardiography.
- MUGA represents a promising imaging modality for assessing diastolic function and diagnosing HFpEF in this patient population.
Background:
In recent years, heart failure with preserved ejection fraction (HFpEF) has received increasing clinical attention. To investigate the diagnostic value of diastolic function parameters derived from planar gated blood-pool imaging (MUGA) for detecting HFpEF in coronary atherosclerotic heart disease (coronary artery disease, CAD) patients.
Methods:
Ninety-seven CAD patients with left ventricular ejection fraction ≥ 50% were included in the study. Based on the left ventricular end-diastolic pressure (LVEDP), the patients were divided into the HFpEF group (LVEDP ≥ 16 mmHg, 47 cases) and the normal LV diastolic function group (LVEDP < 16 mmHg, 50 cases). Diastolic function parameters obtained by planar MUGA include peak filling rate (PFR), filling fraction during the first third of diastole (1/3FF), filling rate during the first third of diastole (1/3FR), mean filling rate during diastole (MFR), and peak filling time (TPF). Echocardiographic parameters include left atrial volume index (LAVI), peak tricuspid regurgitation velocity (peak TR velocity), transmitral diastolic early peak inflow velocity (E), average early diastolic velocities of mitral annulars (average e'), average E/e' ratio. The diastolic function parameters obtained by planar MUGA were compared with those obtained by echocardiography to explore the clinical value of planar MUGA for detecting HFpEF.
Results:
The Receiver-operating characteristic curve analysis of diastolic function parameters obtained from planar MUGA and echocardiography to detect HFpEF showed that: among the parameters examined by planar MUGA, the area under the curve (AUC) of PFR, 1/3FF, 1/3FR, MFR and TPF were 0.827, 0.662, 0.653, 0.663 and 0.809, respectively. Among the echocardiographic parameters, the AUCs for average e', average E/e' ratio, peak TR velocity, and LAVI values were 0.747, 0.706, 0.735, and 0.633. The combination of PFR and TPF showed an AUC of 0.856. PFR combined with TPF value demonstrated better predictive value than average e' (Z = 2.020, P = 0.043).
Conclusion:
Diastolic function parameters obtained by planar MUGA can be used to diagnose HFpEF in CAD patients. PFR combined with TPF was superior to the parameters obtained by echocardiography and showed good sensitivity and predictive power for detecting HFpEF.
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