Document Detail


Prognostic value of repeated 123I-metaiodobenzylguanidine imaging in patients with dilated cardiomyopathy with congestive heart failure before and after optimized treatments--comparison with neurohumoral factors.
MedLine Citation:
PMID:  12074268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The present study was undertaken to assess whether repeated measurement of cardiac 123I-metaiodobenzylguanidine (MIBG) imaging parameters before and after optimized treatments is useful for predicting the prognosis of patients with congestive heart failure (CHF) resulting from dilated cardiomyopathy (DCM). The subjects were 85 consecutive patients with DCM who had a left ventricular ejection fraction (LVEF) of less than 45%. The MIBG and the concentrations of neurohumoral factors were measured at baseline and after 6 months of optimized treatments. Cox proportional hazards analysis was performed to assess the various parameters before and after treatment. Twenty-three patients had a cardiac event (12 died; 11 hospitalized) during a mean follow-up period of 2 years. Although there was no difference between the baseline heart to mediastinum (H/M) ratio measured by MIBG between survivors and nonsurvivors, the H/M ratio was significantly decreased in nonsurvivors after 6 months. Multivariate analysis revealed that a high plasma concentration of brain natriuretic peptide level after 6 months (p=0.0049) and absolute changes in the H/M ratio (p=0.0046) were independent predictors of mortality. Comparison of the H/M ratio on MIBG imaging before and after optimized additional treatment provided useful information for predicting mortality and was independent of clinical and neurohumoral factors previously shown to be associated with poor prognosis in patients with DCM.
Authors:
Toshiki Matsui; Takayoshi Tsutamoto; Keiko Maeda; Junya Kusukawa; Masashiko Kinoshita
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  66     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-20     Completed Date:  2002-12-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  537-43     Citation Subset:  IM    
Affiliation:
First Department of Internal Medicine, Shiga University of Medical Science, Seta, Otsu, Japan.
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MeSH Terms
Descriptor/Qualifier:
3-Iodobenzylguanidine / diagnostic use*
Cardiomyopathy, Dilated / drug therapy*,  physiopathology,  radionuclide imaging*
Cardiotonic Agents / therapeutic use
Female
Heart Failure / drug therapy*,  physiopathology,  radionuclide imaging*
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Norepinephrine / blood
Predictive Value of Tests
Prognosis
Radiopharmaceuticals / diagnostic use
Survival Rate
Time Factors
Ventricular Function, Left / physiology*
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Radiopharmaceuticals; 114471-18-0/Natriuretic Peptide, Brain; 51-41-2/Norepinephrine; 77679-27-7/3-Iodobenzylguanidine

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