Division of Cardiology, Osaka General Medical Center, 3-1-56, Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan.
J Nucl Cardiol. 2020 Jun;27(3):992-1001. doi: 10.1007/s12350-019-01639-6. Epub 2019 Feb 13.
AdreView myocardial imaging for risk evaluation in heart failure (ADMIRE-HF) risk score is a novel risk score to predict serious arrhythmic risk in chronic heart failure patients with reduced ejection fraction (HFrEF). Moreover, early repolarization pattern (ERP) has been shown to be associated with an increased risk of sudden cardiac death (SCD) in HFrEF patients. We sought to investigate the prognostic value of combining ADMIRE-HF risk score and ERP to predict SCD in HFrEF patients.
We studied 90 HFrEF outpatients with LVEF< 40% in our prospective cohort study. In cardiac MIBG imaging, the heart-to-mediastinum (H/M) ratio was measured on the delayed planar image. ADMIRE-HF risk score was derived from the sum of the point values of LVEF, H/M ratio, and systolic blood pressure. We also assessed ERP on the standard electrocardiogram.
During a median follow-up of 7.5(4.5-12.0) years, 22 patients had SCD. At multivariate Cox analysis, ADMIRE-HF risk score and ERP were independently associated with SCD. Patients with both intermediate/high ADMIRE-HF score and ERP had a higher SCD risk than those with either and none of them.
The combination of ADMIRE-HF risk score and ERP would provide the incremental prognostic information for predicting SCD in HFrEF patients.
用于心力衰竭（ADMIRE-HF）风险评分的 AdreView 心肌成像风险评分是一种预测射血分数降低的慢性心力衰竭（HFrEF）患者严重心律失常风险的新型风险评分。此外，早期复极模式（ERP）已被证明与 HFrEF 患者心源性猝死（SCD）风险增加相关。我们试图研究 ADMIRE-HF 风险评分与 ERP 相结合预测 HFrEF 患者 SCD 的预后价值。
我们在前瞻性队列研究中研究了 90 名 LVEF<40%的 HFrEF 门诊患者。在心脏 MIBG 成像中，在延迟平面图像上测量心脏与纵隔（H/M）比值。ADMIRE-HF 风险评分是由 LVEF、H/M 比值和收缩压的点值之和得出的。我们还评估了标准心电图上的 ERP。
在中位数为 7.5（4.5-12.0）年的随访期间，有 22 名患者发生 SCD。在多变量 Cox 分析中，ADMIRE-HF 风险评分和 ERP 与 SCD 独立相关。同时具有中/高 ADMIRE-HF 评分和 ERP 的患者比那些具有两者之一或两者均无的患者发生 SCD 的风险更高。
ADMIRE-HF 风险评分和 ERP 的结合将为预测 HFrEF 患者 SCD 提供额外的预后信息。
