Relationship between evaluation by quantitative fatty acid myocardial scintigraphy and response to β-blockade therapy in patients with dilated cardiomyopathy

• Published in: European journal of nuclear medicine 2001-12, Vol.28 (12), p.1811-1816
• Main Authors: ITO, Tatsuo, HOSHIDA, Shiro, NISHINO, Masami, AOI, Toshiyuki, EGAMI, Yasuyuki, TAKEDA, Toshihiro, KAWABATA, Masayoshi, TANOUCHI, Jun, YAMADA, Yoshio, KAMADA, Takenobu
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Biological and medical sciences; Cardiology. Vascular system; Cardiomyopathy, Dilated - diagnostic imaging; Cardiomyopathy, Dilated - drug therapy; Cardiovascular system; Fatty Acids; Female; Heart; Heart - diagnostic imaging; Humans; Investigative techniques, diagnostic techniques (general aspects); Iodine Radioisotopes; Iodobenzenes; Male; Medical sciences; Metoprolol - therapeutic use; Middle Aged; Myocarditis. Cardiomyopathies; Myocardium - metabolism; Predictive Value of Tests; Radionuclide Imaging; Radionuclide investigations; Sensitivity and Specificity
• ISSN: 0340-6997; 1619-7070; 1619-7089
• DOI: 10.1007/s00259-001-0668-2

Predicting the effect of beta-blockade therapy on the clinical outcome of patients with dilated cardiomyopathy (DCM) is difficult prior to the initiation of therapy. Myocardial fatty acid metabolism has been shown to be impaired in patients with DCM. We examined whether the extent of myocardial injury, as assessed by iodine-123 15-( p-iodophenyl)-3- R, S-methylpentadecanoic acid (BMIPP) myocardial scintigraphy, is related to the response of patients with DCM to beta-blockade therapy. Thirty-seven patients with DCM were examined using BMIPP myocardial scintigraphy before and after 6 months of treatment with metoprolol. Myocardial BMIPP uptake (%BM uptake) was estimated quantitatively as a percentage of the total injected count ratio. The left ventricular end-diastolic and end-systolic dimensions (LVDd, LVDs) and ejection fraction (LVEF) were also evaluated. The patients were divided into two groups according to their functional improvement (>10% elevation of LVEF) after 6 months of metoprolol therapy. Twenty-eight patients responded to the therapy, while nine did not. Prior to the therapy, no significant differences in LVDd, LVDs or LVEF were observed between the responders and non-responders. However, the %BM uptake was significantly lower in the non-responders than in the responders (1.0%+/-0.2% vs 2.1%+/-0.5%, P