Association of Summed Rest Score on Technetium‐99m Sestamibi With Exercise Capacity and Incident Adverse Outcomes in Hospitalized Patients With Nonischemic Cardiomyopathy: A Retrospective Analysis
Key result
Decreased myocardial 99mTc-MIBI uptake is linked to impaired exercise capacity and adverse clinical outcomes.
- P<0.001
- n=182
Why the study?
In nonischemic cardiomyopathy, the clinical relevance of decreased resting myocardial 99mTc-MIBI uptake regarding exercise capacity and clinical outcomes remained incompletely understood.
Does higher summed rest score on 99mTc-MIBI scintigraphy predict impaired exercise capacity and adverse clinical outcomes in patients with nonischemic cardiomyopathy?
Population
182 patients with nonischemic cardiomyopathy and LVEF <50%
Comparison
Decreased resting myocardial 99mTc-MIBI uptake assessed by summed rest score
Design
Retrospective cohort study
Follow-up
Median 807 days
Authors
Discussion
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Implication
May aid risk stratification in nonischemic cardiomyopathy; leaves open whether uptake improves decision-making beyond standard assessment.
Key Points
- To determine whether reduced resting myocardial technetium-99m sestamibi uptake is associated with impaired exercise capacity and adverse clinical outcomes in patients with nonischemic cardiomyopathy.
- Retrospectively analyzed 182 patients (mean age 51.4±14.0 years; 27% female) with nonischemic cardiomyopathy and left ventricular ejection fraction <50% evaluated between 2016 and 2023.
- Assessed resting myocardial uptake using the technetium-99m sestamibi summed rest score (SRS) and evaluated exercise capacity via cardiopulmonary exercise testing, defining impairment as percentage of predicted peak oxygen consumption (PPVO2) ≤60%.
- Monitored patients over a median follow-up of 807 days for a composite endpoint of all-cause death, ventricular assist device implantation, or heart transplantation.
- Impaired exercise capacity (PPVO2 ≤60%) occurred in 41% (74/182) of patients and was associated with higher median SRS (12 vs. 8; P < 0.001), remaining statistically significant after adjusting for left ventricular ejection fraction, brain natriuretic peptide, and heart failure duration.
- The composite adverse outcome occurred in 13% (23/182) of patients and remained significantly associated with higher SRS after adjusting for PPVO2 ≤60%.
- Stratification by median SRS (9) and PPVO2 (60%) demonstrated that patients with both high SRS and low PPVO2 had the highest incidence of adverse clinical events.
Study Design
Type
Cohort (n=182)
Structured PICO
Does higher summed rest score on 99mTc-MIBI scintigraphy predict impaired exercise capacity and adverse clinical outcomes in patients with nonischemic cardiomyopathy?
P
Population
182 patients (mean age 51.4 years, 27% female) with nonischemic cardiomyopathy and LVEF <50% who underwent 99m Tc-MIBI scintigraphy and cardiopulmonary exercise testing, followed for a median of 807 days.
E
Exposure
Myocardial technetium-99m sestamibi (99mTc-MIBI) scintigraphy with evaluation of summed rest score (SRS)
O
Outcome
Impaired exercise capacity (percentage of predicted peak oxygen consumption ≤60%) and a composite outcome of all-cause death, ventricular assist device implantation, or heart transplantationcomposite
Main Result
p-value: p=<0.001
Decreased resting myocardial 99mTc-MIBI uptake (higher SRS) provides prognostic information complementary to exercise capacity in patients with nonischemic cardiomyopathy.
Cite This Study
Mima et al. (2026) conducted a cohort in Nonischemic cardiomyopathy (n=182). Decreased myocardial 99m Tc-MIBI uptake (higher summed rest score) vs. Preserved myocardial 99m Tc-MIBI uptake (lower summed rest score) was evaluated on Impaired exercise capacity (percentage of predicted peak oxygen consumption ≤60%) and a composite of all-cause death, ventricular assist device implantation, or heart transplantation (p=<0.001). Decreased myocardial 99m Tc-MIBI uptake (higher summed rest score) was significantly associated with impaired exercise capacity (median SRS 12 vs 8; P<0.001) and adverse clinical outcomes.