Abstract 13059: Diagnostic Performance of Left Ventricular Contractile Entropy in Patients With Heart Failure: Analysis by Quantitative Gated Semiconductor-SPECT

Abstract

Background: Left ventricular (LV) dyssynchrony is considered as an important cause of congestive heart failure (CHF) admission. However, among the parameters of dyssynchrony, the prognostic value of LV contractile entropy is not elucidated. Hypothesis: Left ventricular contractile entropy can predict early re-hospitalization of heart failure patients. Method: Ninety-eight consecutive patients with first onset CHF who underwent quantitative gated demiconductor SPECT (QGS) before discharge were investigated retrospectively. Patients with re-hospitalization after discharge within 30-days were assigned to Group A, and patients without re-hospitalization were assigned to Group B. Data regarding electrocardiogram, and parameters of QGS including LV remodeling, systolic function, diastolic function and phase analysis (Phase SD, bandwidth, entropy) were collected automatically, and compared between Group A and B. Kaplan-Meier survival curves were used to compare variables between the patients, as appropriate. Multivariate analysis was performed on variables with a value of P < 0.05 using the stepwise regression approach. Result (See figure and table): Of 98 patients, 92 patients did not readmit and other 6 patients readmitted within 30-days. ROC analysis showed that the cut-off value 0.785 predicted Group A (95% CI: 0.563-0.894) with 0.652 specificity and 0.833 sensitivity. Multivariate analysis showed that ‘entropy > 0.785’ was a significant and independent predictor with a high odds ratio (OR:9.375, 95%CI :1.050-83.724). The Kaplan-Meier survival curve revealed a significant difference between the patients of ‘entropy ≧ 0.785’ and ‘entropy < 0.785’ in 30-days re-hospitalization rate (Log-rank test, p=0.016). Conclusion: The LV contractile entropy was a powerful indicator of early phase re-hospitalization in patients with CHF, rather than ejection fraction or other parameters of LV dyssynchrony.