Document Detail


Evaluation of cardiac sympathetic nerve activity and left ventricular remodelling in patients with dilated cardiomyopathy on the treatment containing carvedilol.
MedLine Citation:
PMID:  17409109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: It has been reported that carvedilol improves cardiac sympathetic nerve activity (CSNA) in patients with dilated cardiomyopathy (DCM). However, the influence of carvedilol on cardiac (123)I-meta-iodobenzylguanidine (MIBG) scintigraphic findings and left ventricular (LV) remodelling has not been determined in DCM patients. METHODS AND RESULTS: In 30 patients with DCM and 10 normal controls, the delayed heart/mediastinum count (H/M) ratio, delayed total defect score (TDS), and washout rate (WR) were determined by (123)I-MIBG scintigraphy. In addition, the left ventricular end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), and LV ejection fraction (LVEF) were calculated by echocardiography. In the DCM patients, the regional defect score index (RDSI), regional washout rate index (RWRI), and wall motion score index (WMSI) were also determined to evaluate regional adrenergic dysfunction and wall motion. Examinations were repeated in all DCM patients after standard treatment containing carvedilol at a dose of 10-20 mg/day (mean dose: 16 +/- 4 mg/day) for a mean of 12 +/- 1 months. Both the (123)I-MIBG scintigraphic and echocardiographic parameters were significantly worse in the DCM patients than the normal control subjects. After treatment, all of these parameters improved significantly in the DCM patients. There was a significant correlation between the changes of (123)I-MIBG findings and changes of the LVEDV and LVESV after treatment. Moreover, there was a significant correlation between changes of the WMSI and those of the RDSI or RWRI in DCM patients. CONCLUSION: Both (123)I-MIBG scintigraphic parameters and echocardiographic parameters were improved in the DCM patients. There was a significant correlation between the changes of (123)I-MIBG scintigraphic and echocardiographic findings after treatment. These findings implicate that long-term, including carvedilol, therapy can improve both CSNA and LV remodelling in patients with DCM.
Authors:
Shu Kasama; Takuji Toyama; Takashi Hatori; Hiroyuki Sumino; Hisao Kumakura; Yoshiaki Takayama; Shuichi Ichikawa; Tadashi Suzuki; Masahiko Kurabayashi
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-04-04
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-20     Completed Date:  2007-11-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  989-95     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Gunma University School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-0034, Japan. s-kasama@bay.wind.ne.jp
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use
Adrenergic beta-Antagonists / therapeutic use*
Adult
Aged
Blood Pressure / physiology
Carbazoles / therapeutic use*
Cardiomyopathy, Dilated / drug therapy,  physiopathology*,  radionuclide imaging
Echocardiography
Female
Heart / innervation*
Heart Rate / physiology
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / metabolism
Propanolamines / therapeutic use*
Prospective Studies
Radiopharmaceuticals / diagnostic use
Stroke Volume / physiology
Sympathetic Nervous System / drug effects*
Tomography, Emission-Computed, Single-Photon / methods
Ventricular Remodeling / physiology*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Carbazoles; 0/Propanolamines; 0/Radiopharmaceuticals; 114471-18-0/Natriuretic Peptide, Brain; 72956-09-3/carvedilol; 77679-27-7/3-Iodobenzylguanidine
Comments/Corrections
Comment In:
Eur Heart J. 2007 Apr;28(8):922-3   [PMID:  17409108 ]

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