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Prognostic values of coronary artery calcium score and 123I-BMIPP SPECT in patients with non-ischemic heart failure with preserved ejection fraction

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Abstract

This study aimed to determine whether coronary artery calcium score (CACS) can be a prognostic indicator for the development of major adverse cardiac events (MACEs) and compare the value of CACS with that of the 123I-betamethyl-p-iodophenyl-pentadecanoic acid (123I-BMIPP) defect score (BDS) in patients with non-ischemic heart failure with preserved ejection fraction (NIHFpEF). Among 643 consecutive patients hospitalized due to acute heart failure, 108 (74 ± 13y) were identified to have NIHFpEF on non-contrast regular chest computed tomography and 123I-BMIPP single-photon emission computed tomography (SPECT). We evaluated whether CACS and BDS were associated with MACEs using multivariate Cox models. Thirty-two MACEs developed at a mean follow-up period of 2.4 years. CACS > 0 (hazard ratio [HR] 2.38, 95% confidence interval [CI] 1.02–5.54) and higher BDS (HR 16.00, 95% CI 5.88–43.49) were significantly associated with the development of MACEs. The proportion of patients who experienced MACEs was significantly higher in the CACS > 0 and high BDS group than in the CACS = 0 and low BDS group (3% vs. 75%, p < 0.001). CACS, as well as BDS, could serve as potential prognostic indicators in patients with NIHFpEF.

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Acknowledgements

We are grateful to the radiology technologists Mr. Tadashi Kokubo, Mr. Kazuhiro Tachiki, Mr. Nobutomo Ishii, Mr. Takushi Okubo, and Mr. Fuyuki Washizuka for their technical assistance in the administration of 123I-BMIPP SPECT and chest CT.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1, Omorinishi, Ota-ward, Tokyo, 143-8541, Japan

    Hidenobu Hashimoto, Rine Nakanishi, Yukiko Hashimoto, Yuriko Okamura, Kyoko Ota, Junichi Yamazaki & Takanori Ikeda

  2. Department of Radiology, Faculty of Medicine, Toho University, Tokyo, Japan

    Sunao Mizumura

Authors
  1. Hidenobu Hashimoto
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  2. Rine Nakanishi
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  3. Sunao Mizumura
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  4. Yukiko Hashimoto
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  5. Yuriko Okamura
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  6. Kyoko Ota
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  7. Junichi Yamazaki
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  8. Takanori Ikeda
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by HH, RN, YH, YO and KO. HH performed the statistical analyses and drafted the manuscript. SM, JY and TI reviewed and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hidenobu Hashimoto.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The institutional review board approved this retrospective study and the requirement to obtain informed consent was waived (M20136).

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Comprehensive agreement was obtained from all patients in the form of an opt-out on the institution’s web-site.

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The data that support the findings of this study are available from the corresponding author.

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Hashimoto, H., Nakanishi, R., Mizumura, S. et al. Prognostic values of coronary artery calcium score and 123I-BMIPP SPECT in patients with non-ischemic heart failure with preserved ejection fraction. Int J Cardiovasc Imaging 37, 3573–3581 (2021). https://doi.org/10.1007/s10554-021-02332-x

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  • DOI: https://doi.org/10.1007/s10554-021-02332-x

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