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Erschienen in:
01.10.2004 | Original Article
Usefulness of 123I-metaiodobenzylguanidine myocardial scintigraphy for predicting the effectiveness of β-blockers in patients with dilated cardiomyopathy from the standpoint of long-term prognosis
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 10/2004
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Purpose
The usefulness of 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy in predicting the effectiveness of β-blocker therapy in dilated cardiomyopathy (DCM) was investigated from the standpoint of long-term prognosis.
Methods
The subjects were 53 DCM patients in whom β-blockers had been successfully introduced and used for 6 months or longer. When symptoms were stable before the introduction of β-blockers and for up to 1 year thereafter, MIBG myocardial single-photon emission computed tomography was performed and the images analysed to obtain the extent score (EXT), severity score (SEV) and washout rate (WR). At the same time, echocardiography was performed to measure left ventricular ejection fraction (LVEF). Thereafter, patients were placed under observation for an average of 1,314±986 days, with the occurrence of cardiac events as the endpoint.
Results
The degree of improvement in WR after introduction of β-blockers was a significant predictor of cardiac events. In fact, none of the patients whose improvement in WR was valued at 10 or higher had cardiac events. Accordingly, using improvement in WR of 10 as the cut-off value, the patients were divided into two groups, “improved” and “unimproved”. There were significant differences between the groups in respect of early EXT, early SEV and WR before the introduction of β-blockers . As regards predictors of WR improvement, multivariate logistic regression analysis demonstrated that early EXT, WR and LVEF were significant predictors.
Conclusion
This study shows that, from the standpoint of long-term prognosis, DCM patients who would benefit the most from β-blocker therapy are those with low early EXT and early SEV and high WR before β-blocker introduction regardless of LVEF values.