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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.01.2013 | Original Article

Myocardial ¹²³I-MIBG scintigraphy predicts an impairment in myocardial functional reserve during dobutamine stress in patients with idiopathic dilated cardiomyopathy

verfasst von: Satoru Ohshima, Satoshi Isobe, Daisuke Hayashi, Shinji Abe, Katsuhiko Kato, Toyoaki Murohara

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2013

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Abstract

Purpose

We investigated whether myocardial ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG) scintigraphy predicts impairment of myocardial functional reserve in response to dobutamine stress in patients with idiopathic dilated cardiomyopathy (DCM).

Methods

Forty DCM patients (LVEF 39 ± 12 %) underwent myocardial ¹²³I-MIBG scintigraphy, echocardiography, and cardiac catheterization. Myocardial ¹²³I-MIBG uptake was quantified as the delayed heart to mediastinum (H/M) ratio and washout rate (WR). Local denervation was evaluated on polar map images. LV dP/dt _max and T_1/2 were determined from left ventricular pressure curves at baseline and during dobutamine infusion (15 μg/kg /min). Patients were classified into two groups as follows: group A comprised 21 patients showing a delayed H/M ratio of <1.9 (median value); group B comprised 19 patients showing a delayed H/M ratio of ≥1.9.

Results

The percentage change in heart rate (%HR), LV dP/dt _max (%LV dP/dt _max), and T _1/2 (%T _1/2) from baseline to dobutamine stress were significantly more reduced in group A than in group B (39.3 ± 20.2 %, 55.2 ± 24.1 %, p < 0.01; 102.3 ± 46.3 %, 152.0 ± 72.3 %, p < 0.05; 38.7 ± 15.3 %, 46.9 ± 15.4 %, p < 0.05, respectively). No significant differences between the two groups were observed in the echocardiographic parameters or baseline cardiac catheterization parameters. Significant correlations were found between delayed H/M ratio and %HR (r = 0.35, p < 0.05), %LV dP/dt _max (r = 0.45, p < 0.05) and %T _1/2 (r = 0.34, p < 0.05). Significant inverse correlations were also found between WR and %HR (r = −0.37, p < 0.05), %LV dP/dt _max (r = −0.60, p < 0.0001), and %T _1/2 (r = −0.34, p < 0.05). SPECT images revealed enhanced denervation from the inferoposterior to anterior wall in accordance with the advancement of global denervation.

Conclusion

Reduced ¹²³I-MIBG uptake and increased washout were related to impairment in adrenergic myocardial functional reserve in idiopathic DCM.

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Titel: Myocardial 123I-MIBG scintigraphy predicts an impairment in myocardial functional reserve during dobutamine stress in patients with idiopathic dilated cardiomyopathy
verfasst von: Satoru Ohshima
Satoshi Isobe
Daisuke Hayashi
Shinji Abe
Katsuhiko Kato
Toyoaki Murohara
Publikationsdatum: 01.01.2013
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2013
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-012-2256-z

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Myocardial ¹²³I-MIBG scintigraphy predicts an impairment in myocardial functional reserve during dobutamine stress in patients with idiopathic dilated cardiomyopathy

Abstract

Purpose

Methods

Results

Conclusion

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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