[Prediction of cardiac sympathetic nerve activity and cardiac functional outcome after treatment in patients with dilated cardiomyopathy: examination using dobutamine gated blood pool scintigraphy]

Autor: S, Kasama, T, Toyama, H, Hoshizaki, S, Oshima, K, Taniguchi, T, Iwasaki, T, Suzuki, R, Nagai
Rok vydání: 2000
Předmět:
Zdroj: Journal of cardiology. 36(1)
ISSN: 0914-5087
Popis: This study evaluated whether dobutamine gated blood pool scintigraphy can predict improvement of cardiac sympathetic nerve activity and cardiac function.Sixteen patients(10 men and 6 women, mean age 59 +/- 13 years) with dilated cardiomyopathy underwent dobutamine gated blood pool scintigraphy to measure left ventricular ejection fraction (LVEF) using tracer at 0, 5, 10 and 15 micrograms/kg/min before treatment. Patients were divided into good responders (LVEF increaseor = 15%) 8 patients(GR Group) and poor responders(LVEF increase15%) 8 patients (PR Group) after treatment with beta-blocker or amiodarone with a background treatment of digitalis, diuretics and angiotensin converting enzyme inhibitor. I-123 metaiodobenzylguanidine(MIBG) imaging to evaluate cardiac sympathetic nerve activity and echocardiography were performed before and at one year after treatment. MIBG imaging was obtained 4 hours after tracer injection, and the heart/mediastinum count ratio(H/M ratio) calculated from the anterior planar image and the total defect score(TDS) from the single photon emission computed tomography image. LVEF and left ventricular endo-diastolic dimension (LVDd) were measured by echocardiography and New York Heart Association(NYHA) functional class was evaluated.The GR Group showed TDS decreased from 28 +/- 6 to 17 +/- 12(p0.05), H/M ratio increased from 1.79 +/- 0.26 to 2.07 +/- 0.32(p0.05), LVEF increased from 29 +/- 8% to 48 +/- 10%(p0.01), and LVDd decreased from 65 +/- 4 mm to 58 +/- 5 mm(p0.05). In contrast, the PR Group showed no significant changes in TDS, H/M ratio, LVEF and LVDd. NYHA functional class improved in both groups. The improvement was better in the GR Group than in the PR Group.Dobutamine gated blood pool scintigraphy is useful to predict the improvement of the cardiac sympathetic nerve activity and cardiac function, and symptoms after treatment in patients with dilated cardiomyopathy.
Databáze: OpenAIRE