Use of iodine-123 metaiodobenzylguanidine myocardial imaging to predict the effectiveness of β-blocker therapy in patients with dilated cardiomyopathy

被引：0

作者：

Fukuoka S. ^{[1
]}

Hayashida K. ^{[1
,4
]}

Hirose Y. ^{[1
]}

Shimotsu Y. ^{[1
]}

Ishida Y. ^{[1
]}

Kakuchi H. ^{[2
]}

Eto T. ^{[3
]}

机构：

[1] Department of Radiology, National Cardiovascular Center, Osaka

[2] Department of Internal Medicine, National Cardiovascular Center, Osaka

[3] First Dept. of Internal Medicine, Miyazaki Medical College, Miyazaki

[4] Department of Radiology, National Cardiovascular Center, Suita, Osaka 565

来源：

European Journal of Nuclear Medicine | 1997年 / 24卷 / 5期

关键词：

Bull's eye map; Dilated cardiomyopathy; Drug effectiveness; Iodine-123; metaiodobenzylguanidine; β-blocker therapy;

D O I：

10.1007/BF01267684

中图分类号：

学科分类号：

摘要：

It is crucial to predict drug effectiveness in chronic disease, such as dilated cardiomyopathy (DCM), in which the left ventricular (LV) function might be improved by β-blocker therapy. As the functional improvement effected by β-blocker therapy takes more than 2 months, we investigated whether iodine-123 metaiodobenzylguanidine (123I-MIBG) imaging could be used to predict drug effectiveness. We studied 13 patients (11 men and two women; mean age, 43 ± 13 years) with DCM and seven normal subjects (six men and one woman; mean age, 48 ± 16 years). We obtained myocardial single-photon emission tomography (SPET) images 15 min and 4 h after administration of 123I-MIBG (111 MBq). Studies were performed in the patients with DCM before and 1 and 3 months after the administration of metoprolol and in the normal subjects. We calculated the regional 123I-MIBG washout rate (r-WR) in the SPET image, and the global 123I-MIBG washout rate (g-WR) and heart-mediastinum activity ratio (H/M) using the anterior planar image. We classified patients into those showing a ≤ 5% increase in LV ejection fraction (LVEF) at 3 months compared with LVEF values before the treatment (group I, n = 7) and those showing a < 5% increase in LVEF (group II, n = 6). In group I, the r-WR values at pretreatment and at 1 month and 3 months of treatment, respectively, were 36% ± 19%, 29% ± 14%* and 25% ± 13%* in the anterior segment, 39% ± 17%, 33% ± 17%** and 28% ± l7%** in the lateral segment, 36% ± 16%, 31% ± 14%* and 22% ± 2%** in the septal segment and 40% ± 11%, 37% ± 19% and 31% ± 18%* in the inferior segment; the g-WR was 45% ± 11%, 43% ± 10% and 34% ± 9%*, respectively (*P < 0.05, **P < 0.01 vs pretreatment). In group II, there were no significant changes in regional or global parameters during the 3-month period. In normal subjects, the r-WR values in each of the anterior, lateral, septal and inferior segments were significantly lower than those in groups I and II. These values were 18% ± 9%, 18% ± 15%, 20% ± 12% and 21% ± 15%, respectively. This study demonstrated that with regional assessment 123I-MIBG SPET imaging can be used to predict the functional improvement of LVEF at 1 month of β-blocker therapy in patients with DCM.

引用

页码：523 / 529

页数：6

共 29 条

[1]

Waagstein F., Hjalmarson A., Varnauskas E., Et al., Effect of chronic beta-adrenergic receptor blockade in congestive cardiomyopathy, Br Heart J, 37, pp. 1022-1036, (1975)

[2]

Hjalmarson A., Waagstein F., New therapeutic strategies in chronic heart failure: Challenge of long-term beta-blockade, Eur Heart J, 12, SUPPL. F, pp. 63-69, (1991)

[3]

Gilbert E.M., Mestroni L., Anderson J.L., Et al., Can response to beta-blocker therapy in idiopathic dilated cardiomyopathy be predicted by baseline parameters?, Circulation, 80, 2 SUPPL., (1989)

[4]

Sisson J.C., Wieland D.M., Sherman P., Et al., Meta-iodobenzyl-guanidine as an index of the adrenergic nervous system integrity and function, J Nucl Med, 28, pp. 1620-1624, (1987)

[5]

Mitrani R.D., Klein L.S., Miles M.W., Et al., Regional cardiac sympathetic denervation in patients with ventricular tachycardia in the absence of coronary artery disease, J Am Coll Cardiol, 22, pp. 1344-1353, (1993)

[6]

Gill J.S., Hunter G.J., Gane J., Et al., Asymmetry of cardiac [<sup>123</sup>I]meta-iodobenzyl-guanidine scans in patients with ventricular tachycardia and a "clinically normal" heart, Br Heart J, 69, pp. 6-13, (1993)

[7]

Yamakado K., Takeda K., Kitano T., Et al., Serial change of iodine-123 metaiodobenzylguanidine (MIBG) myocardial concentration in patients with dilated cardiomyopathy, Eur J Nucl Med, 19, pp. 265-270, (1992)

[8]

Schofer J., Spielmann R., Schuchert A., Et al., Iodine-123 metaiodobenzylguanidine scintigraphy: A noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy, J Am Coll Cardiol, 12, pp. 1252-1258, (1988)

[9]

Henderson E.B., Kahn J.K., Corbett J.R., Et al., Abnormal I-123 metaiodobenzylguanidine myocardial washout and distribution may reflect myocardial adrenergic derangement in patients with congestive cardiomyopathy, Circulation, 78, pp. 1192-1199, (1988)

[10]

Dae M.W., De Marco T., Botvinick E.H., Et al., Scintigraphic assessment of MIBG uptake in globally denervated human and canine hearts: Implications for clinical studies, J Nucl Med, 33, pp. 1444-1450, (1992)

← 1 2 3 →