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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 11/2008

01.11.2008 | Original Article

Prognostic value of sympathetic innervation and cardiac asynchrony in dilated cardiomyopathy

verfasst von: Alain Manrique, Mathieu Bernard, Anne Hitzel, Fabrice Bauer, Jean-François Ménard, Rémi Sabatier, Arnold Jacobson, Pierre Véra, Denis Agostini

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2008

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Abstract

Purpose

The purpose of the study is to examine prognostic values of cardiac I-123 metaiodobenzylguanidine (MIBG) uptake and cardiac dyssynchrony in patients with dilated cardiomyopathy (DCM).

Materials and methods

Ninety-four patients with non-ischemic DCM underwent I-123 MIBG imaging for assessing cardiac sympathetic innervation and equilibrium radionuclide angiography. Mean phase angles and SD of the phase histogram were computed for both right ventricular (RV) and left ventricular (LV). Phase measures of interventricular (RV–LV) and intraventricular (SD–RV and SD–LV) asynchrony were computed.

Results

Most patients were receiving beta-blockers (89%) and angiotensin-converting enzyme inhibitors (88%). One patient (1%) was lost to follow-up, six had cardiac death (6.4%), eight had heart transplantation (8.6%), and seven had unplanned hospitalization for heart failure (7.5%; mean follow-up: 37 ± 16 months). Patients with poor clinical outcome were older, had higher The New York Heart Association functional class, impaired right ventricular ejection fraction and left ventricular ejection fraction, and impaired cardiac I-123 MIBG uptake. On multivariate analysis, I-123 MIBG heart-to-mediastinum (H/M) uptake ratio <1.6 was the only predictor of both primary (cardiac death or heart transplantation, RR = 7.02, p < 0.01) and secondary (cardiac death, heart transplantation, or recurrent heart failure, RR = 8.10, p = 0.0008) end points.

Conclusions

In patients receiving modern medical therapy involving beta-blockers, I-123 MIBG uptake, but not intra-LV asynchrony, was predictive of clinical outcome. The impact of beta-blockers on the prognostic value of ventricular asynchrony remains to be clarified.
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Metadaten
Titel
Prognostic value of sympathetic innervation and cardiac asynchrony in dilated cardiomyopathy
verfasst von
Alain Manrique
Mathieu Bernard
Anne Hitzel
Fabrice Bauer
Jean-François Ménard
Rémi Sabatier
Arnold Jacobson
Pierre Véra
Denis Agostini
Publikationsdatum
01.11.2008
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2008
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-008-0889-8

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