Matsuo Shinro, Nakae Ichiro, Masuda Daisuke, Matsumoto Tetsuya, Horie Minoru
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Shiga.
Intern Med. 2006;45(7):465-7. doi: 10.2169/internalmedicine.45.1696. Epub 2006 May 1.
A 70-year-old man with alcoholic cardiomyopathy underwent 99mtechnetium-sestamibi (MIBI), iodine-123-labeled metaiodobenzylguanidine (MIBG) scintigraphy and Iodine-123-labeled beta-methyl-iodophenyl pentadecanoic acid (BMIPP) scintigraphy. 99mtechnetium-MIBI identified myocardial damage in the inferior wall of left ventricle. (123)I BMIPP showed low uptake in the inferior wall of the myocardium, concordant to perfusion. (123)I BMIPP and (123)I MIBG showed reduced uptake in the inferior segment of the myocardium, indicating impairment of fatty acid metabolism and sympathetic abnormalities. Damaged myocardium was demonstrated in alcoholic cardiomyopathy. Beta blocker (carvedilol) and angiotensin-receptor blocker (valsartan) were started at low doses, then increased gradually, leading to the improvement of cardiac performance. Cardiac sympathetic nerve function, impaired due to alcoholic cardiomyopathy, was improved with beta-blocker therapy. Cardiac scintigraphy may be useful to assess the extent of myocardial improvement and the response to therapy.
一名患有酒精性心肌病的70岁男性接受了锝-99m-甲氧基异丁基异腈（MIBI）、碘-123标记的间碘苄胍（MIBG）闪烁扫描和碘-123标记的β-甲基碘代苯十五烷酸（BMIPP）闪烁扫描。锝-99m-MIBI显示左心室下壁存在心肌损伤。碘-123-BMIPP显示心肌下壁摄取降低，与灌注情况一致。碘-123-BMIPP和碘-123-MIBG显示心肌下节段摄取减少，提示脂肪酸代谢受损和交感神经异常。酒精性心肌病中存在受损心肌。开始给予低剂量的β受体阻滞剂（卡维地洛）和血管紧张素受体阻滞剂（缬沙坦），然后逐渐增加剂量，从而使心脏功能得到改善。酒精性心肌病所致的心脏交感神经功能受损通过β受体阻滞剂治疗得到改善。心脏闪烁扫描可能有助于评估心肌改善程度和对治疗的反应。
