Related Experiment Video
Updated: Jul 9, 2025
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Validation of a Five-Year Prognostic Model Using 123I-metaiodobenzylguanidine Scintigraphy in Patients with Heart
Yohei Ishibashi1, Shu Kasama1,2,3, Masahiko Kurabayashi1
1Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan.
Insights
This study validates a prognostic model using iodine-123 meta-iodobenzylguanidine (MIBG) scintigraphy to predict mortality risk in heart failure patients. The model
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- 123I-metaiodobenzylguanidine (MIBG) scintigraphy is crucial for assessing heart failure severity and prognosis.
- A multicenter study proposed a prognostic model for heart failure mortality prediction using 123I-MIBG scintigraphy data.
- This study aimed to validate the clinical utility of this prognostic model in a real-world patient database.
Purpose of the Study:
- To evaluate the effectiveness of a proposed prognostic model based on 123I-MIBG scintigraphy in predicting 5-year mortality in heart failure patients.
- To compare the predictive accuracy of the model using predischarge and 6-month postdischarge scintigraphy parameters.
- To assess the model's ability to stratify heart failure patients into different mortality risk groups.
Main Methods:
- A cohort of 208 patients with decompensated heart failure requiring hospitalization was retrospectively analyzed.
- 123I-MIBG scintigraphy and echocardiography were performed before hospital discharge and at 6 months postdischarge.
- The prognostic model calculated the 5-year mortality risk, and patients were categorized into three risk tertiles.
Main Results:
- Over a median follow-up of 4.83 years, 56 cardiac deaths occurred among 208 patients.
- Both predischarge and 6-month postdischarge assessments showed significant differences in cardiac death rates across the three risk groups.
- The 6-month postdischarge mortality risk estimation demonstrated a stronger predictive significance compared to the predischarge assessment, particularly between the lowest and highest risk groups.
Conclusions:
- The prognostic model utilizing 123I-MIBG scintigraphy is a valuable tool for predicting mortality risk in heart failure patients.
- The prognostic assessment performed 6 months after hospital discharge provides more accurate mortality risk stratification than the predischarge assessment.
- This model aids in identifying high-risk heart failure patients who may benefit from intensified management strategies.
Abstract:
Background: 123I-metaiodobenzylguanidine (MIBG) scintigraphy evaluates the severity and prognosis of patients with heart failure. A prognostic model has been proposed using a multicenter study data of 123I-MIBG scintigraphy. We evaluated the usefulness of the model using a database. Methods: The study included 208 patients with noncompensated heart failure requiring hospitalization. 123I-MIBG scintigraphy and echocardiography were performed predischarge and 6 months postdischarge. The 5-year mortality rate was calculated by the model and classified into tertiles. Results: In 208 patients, 56 cardiac deaths occurred within the observation period (median, 4.83 years). In the evaluation of predischarge parameters, the predicted 5-year mortality was 15.5% ± 5.0%, 33.5% ± 3.9%, and 51.2% ± 8.2%, and 11 (16.2%), 18 (27.3%), and 27 (36.5%) cardiac deaths occurred in groups 1, 2, and 3, respectively. At the 6-month postdischarge evaluation, the estimated mortality was 8.2% ± 2.2%, 18.5% ± 4.8%, and 43.0% ± 12.1%, and 6 (9.4%), 21 (29.2%), and 29 (40.3%) cardiac deaths occurred, respectively. The predischarge Kaplan-Meier survival analysis showed significant difference between groups 1 and 3 (P value 0.014). Moreover, the 6-month postdischarge evaluation showed significant difference between group 1 and 2, and between groups 1 and 3 (P value 0.016, <0.001, respectively). For groups 1 and 3, the 6-month postdischarge difference was more significant than the predischarge difference (Chi-square 16.7 and 8.1, respectively). Conclusions: The prognostic model using 123I-MIBG scintigraphy was useful in predicting mortality risk in patients with heart failure. The estimated mortality at 6 months postdischarge was more useful than the predischarge estimation for heart failure hospitalization.
