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KMID : 0368120070370100510
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Korean Circulation Journal
2007 Volume.37 No. 10 p.510 ~ p.516
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The Significance of Cardiac Sympathetic Nerve Imaging with 123I-Metaiodobenzylguanidine for Predicting the Occurrence of Ventricular Tachycardia in Patients with Idiopathic Dilated Cardiomyopathy
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Kim Dong-Hee
Shin Dong-Gu
Kim Woong
Lee Sang-Hee
Hong Geu-Ru
Park Jong-Seon
Kim Young-Jo
Shim Bong-Sup
Kang Sang-Wook
Cho Ihn-Ho
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Abstract
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Background and Objective：Ventricular arrhythmia is an important cause of death in patients suffering with idiopathic dilated cardiomyopathy (IDCM). The decreased uptake or increased "washout" of 123I-metaiodobenzylguanidine (MIBG)-derived radioactivity is associated with a worse prognosis or severe disease in patients with cardiac diseases.
Subjects and Methods：Forty patients (28 men, mean age: 56.5±13.0 years) with angiographically proven IDCM were studied and divided into 2 groups: the patients with clinically documented ventricular tachycardia (VT) and IDCM (group A; 17 patients), and the patients without VT, but with IDCM (group B; 23 patients). The normal control group (7 men, mean age 62.4±7.9) was compared theses patients. 123I-MIBG was evaluated by the early (15 min) and delayed (3hours) uptake, the heart to mediastinum uptake (H/M) ratio and the global and regional washout ratio (WOR) that was defined as the [early H uptake-delayed H uptake]/early H uptake. The clinical variables, echocardiographic parameters and 123I-MIBG-derived parameters were compared among three groups.
Results：There were no significant differences in age and the echocardiographic parameters between the groups A and B. A significant negative correlation was present between the early inferior wall H/M ratio and the LVEDD (Spearman’s correlation, r=-0.412, p=0.08), and the early inferior H/M ratio and the LVESD (Spearman’s correlation, r=-0.463, p=0.03). Only the delayed lateral wall uptake was significantly lower in group A than that in group B (23.3±5.3 versus 27.8±8.4, respectively p=0.042). The regional WOR was not statically different among the three groups.
Conclusion：Cardiac 123I-MIBG SPECT partially reflects the vulnerability for the occurrence of VT in patients suffering with IDCM. These results support the feasibility of using cardiac 123I-MIBG SPECT as a prognostic tool in IDCM patients
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KEYWORD
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Cardiomyopathy, dilated, Radionuclide imaging, Tachycardia, ventricular
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