Nakanishi Rine, Fujimoto Shinichiro, Utanohara Yuko, Takamura Kazuhisa, Inoue Aritomo, Yamashina Shohei, Namiki Atsushi, Yamazaki Junichi
Department of Cardiovascular Medicine, Toho University Omori Medical Center, 6-11-1 Omori-nishi, Ohta-ku, Tokyo 143-8541, Japan.
Nucl Med Commun. 2010 Jun;31(6):488-94.
Although it has been reported that (123)I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is useful for assessing the prognosis of dilated cardiomyopathy (DCM), there have been no reports regarding how interval MIBG imaging should be performed during follow-up. We investigated the significance of performing MIBG at different times for the long-term prediction of cardiac events in DCM patients.
The participants were 36 DCM patients who did not sustain cardiac events for 2 years after beta-blocker induction. MIBG was performed 6 months and 2 years after beta-blocker induction and the images analyzed to obtain the extent score, severity score (SEV), and the washout rate. Echocardiography was performed at the same time.
Eight patients experienced a cardiac event during follow-up (cardiac death: two patients; heart failure requiring hospitalization: six patients). Although no significant difference was found in any MIBG parameters or left ventricular ejection fraction between patients who experienced a cardiac event and those who did not after 6 months, early extent score, early SEV, delayed SEV, and washout rate were found to be significantly higher for patients who experienced a cardiac event after 2 years. In multivariate analysis using Cox proportional hazard model, none of the MIBG parameters or left ventricular ejection fraction after 6 months was identified as a predictor of cardiac events. However, delayed SEV after 2 years (hazard ratio 1.067, P = 0.0435) was a significant predictor of cardiac events.
The study suggested that performing MIBG at least once every 2 years allows long-term prediction of cardiac events in the follow-up of DCM patients.
尽管已有报道称，¹²³I-间碘苄胍（MIBG）心肌闪烁显像有助于评估扩张型心肌病（DCM）的预后，但关于在随访期间应如何进行间隔MIBG成像尚无相关报道。我们研究了在不同时间进行MIBG成像对DCM患者心脏事件长期预测的意义。
研究对象为36例DCM患者，这些患者在接受β受体阻滞剂治疗后2年未发生心脏事件。在接受β受体阻滞剂治疗6个月和2年后进行MIBG检查，并对图像进行分析以获得范围评分、严重程度评分（SEV）和洗脱率。同时进行超声心动图检查。
8例患者在随访期间发生了心脏事件（心源性死亡：2例；需要住院治疗的心力衰竭：6例）。尽管在6个月后发生心脏事件的患者和未发生心脏事件的患者之间，任何MIBG参数或左心室射血分数均未发现显著差异，但在2年后发生心脏事件的患者中，早期范围评分、早期SEV、延迟SEV和洗脱率显著更高。在使用Cox比例风险模型进行的多变量分析中，6个月后的任何MIBG参数或左心室射血分数均未被确定为心脏事件的预测指标。然而，2年后的延迟SEV（风险比1.067，P = 0.0435）是心脏事件的显著预测指标。
该研究表明，在DCM患者的随访中，每2年至少进行一次MIBG检查可对心脏事件进行长期预测。
