Yoshinaga K, Tahara M, Torii H, Kihara K
Department of Cardiology, Kagoshima City Medical Association Hospital, Japan.
Ann Nucl Med. 1998 Dec;12(6):341-7. doi: 10.1007/BF03164923.
We examined whether the iodine-123 15-(p-iodophenyl)-3- R,S-methylpentadecanoic acid (BMIPP) myocardial scintigraphy was useful for predicting the treatment response to beta-blocker in patients with dilated cardiomyopathy (DCM). Sixteen patients with DCM were studied. BMIPP single photon emission computed tomography (SPECT) was performed before beta-blocker therapy. The count ratio of the heart (H) to the upper mediastinum (M) (H/M ratio) was calculated. Several measurements including the BMIPP H/M ratio before the administration of metoprorol were retrospectively compared among the 10 "good responders" (showing improvement by at least one NYHA class or an increase in the ejection fraction of > or = 0.10, 6 months after the start of the drug therapy) and the 6 "poor responders." The bull's eye map of BMIPP was divided into 17 areas. Each segmental score was analyzed quantitatively by means of a two-point scoring system (good uptake > or = 67%, poor uptake < 67%). The total score was regarded as the uptake score. The H/M ratio was significantly higher in the good responders than in the poor responders (2.41 +/- 0.24 vs. 1.86 +/- 0.17 p < 0.01). There were no significant differences between the two groups in any other variable data at entry. The uptake score was also a good index for predicting the therapeutic effect. When a relative uptake of 67% or higher was scored as 1, uptake scores of 9 to 17 corresponded to good responses (sensitivity = 100%, specificity = 100%, accuracy = 100%, positive and negative predictive value = 100%). Although the number of patients studied is small, our results suggests that BMIPP myocardial scintigraphy can predict the response to a beta-blocker in patients with DCM.
我们研究了碘-123 15-（对碘苯基）-3-R，S-甲基十五烷酸（BMIPP）心肌闪烁显像是否有助于预测扩张型心肌病（DCM）患者对β受体阻滞剂的治疗反应。对16例DCM患者进行了研究。在β受体阻滞剂治疗前进行了BMIPP单光子发射计算机断层扫描（SPECT）。计算心脏（H）与上纵隔（M）的计数比（H/M比）。回顾性比较了10例“良好反应者”（药物治疗开始6个月后，至少改善一个纽约心脏协会（NYHA）心功能分级或射血分数增加≥0.10）和6例“不良反应者”在服用美托洛尔前的多项测量值，包括BMIPP H/M比。BMIPP的靶心图被分为17个区域。通过两点计分系统（摄取良好≥67%，摄取不良<67%）对每个节段分数进行定量分析。总分被视为摄取分数。良好反应者的H/M比显著高于不良反应者（2.41±0.24对1.86±0.17，p<0.01）。两组在入组时的任何其他变量数据方面均无显著差异。摄取分数也是预测治疗效果的良好指标。当相对摄取率≥67%计为1时，摄取分数9至17对应良好反应（敏感性=100%，特异性=100%，准确性=100%，阳性和阴性预测值=100%）。尽管研究的患者数量较少，但我们的结果表明，BMIPP心肌闪烁显像可以预测DCM患者对β受体阻滞剂的反应。
