Predictive value of myocardial perfusion imaging for all-cause mortality in patients with compound heterozygous familial hypercholesterolemia

Jiao Jian; Wang Luya; Dong Wei; Li Junqi; Mi Hongzhi; Qin Yanwen

doi:10.3760/j.issn.1673-4777.2024.07.005

Abstract：Objective To evaluate the predictive value of myocardial perfusion imaging(MPI)for all-cause mortality risk in patients with compound heterozygous familial hypercholesterolemia(CHFH).Methods Patients with CHFH diagnosed by genetic testing who underwent stress and rest MPI in the Department of Nuclear Medicine,Beijing Anzhen Hospital,Capital Medical University from June 2010 to March 2022 were retrospectively followed up.Total summed stress score(SSS),total summed rest score(SRS)and summed difference score(SDS)of left ventricular myocardial perfusion parameters were obtained by 17-segment 5-point method.The patients were followed up for all-cause mortality,and Cox regression was used to analyze the predictors of all-cause mortality.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of the predictors.Kaplan-Meier analysis and Log-rank test were used to compare the incidence of all-cause mortality in different groups.Results Forty-five patients with CHFH were enrolled and followed up for a median of 6(4,9)years.A total of 11(24.4％)patients died during the follow-up period.The left ventricular myocardial perfusion parameters SSS,SRS and SDS were significantly different between the death group and the survival group(all P＜0.05).Cox regression analysis showed that SRS(Hazard ratio=1.362,95％confidence interval:1.029-1.802,P=0.031)was an independent predictor of all-cause mortality in patients with CHFH.ROC analysis determined that the best cut-off value for predicting death was SRS ≥2.5,and the area under the curve was 0.749.Kaplan-meier survival curve analysis showed that the incidence of all-cause death in SRS≥2.5 group was significantly higher than that in SRS＜2.5 group(Log-rankx2=14.991,P＜0.001).Conclusion MPI is an important imaging method for the risk assessment of all-cause mortality in patients with CHFH,and parameter SRS is an important factor for predic-ting death in such patients.