Document Detail


Myocardial (123)I-MIBG scintigraphy predicts an impairment in myocardial functional reserve during dobutamine stress in patients with idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  23096078     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: We investigated whether myocardial (123)I-metaiodobenzylguanidine ((123)I-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 (123)I-MIBG scintigraphy, echocardiography, and cardiac catheterization. Myocardial (123)I-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 (123)I-MIBG uptake and increased washout were related to impairment in adrenergic myocardial functional reserve in idiopathic DCM.
Authors:
Satoru Ohshima; Satoshi Isobe; Daisuke Hayashi; Shinji Abe; Katsuhiko Kato; Toyoaki Murohara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-25
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  -     ISSN:  1619-7089     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan, kaku@med.nagoya-u.ac.jp.
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