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Journal of Nuclear Medicine Vol. 45 No. 4 527-531
© 2004 by Society of Nuclear Medicine

Clinical Investigations

Gated Myocardial SPECT to Predict Response to ß-Blocker Therapy in Patients with Idiopathic Dilated Cardiomyopathy

Kazuki Fukuchi, MD1, Yoshio Yasumura, MD2, Keisuke Kiso, MD1,3, Kohei Hayashida, MD1, Kunio Miyatake, MD2 and Yoshio Ishida, MD1

1 Department of Radiology, National Cardiovascular Center, Suita, Osaka, Japan
2 Division of Cardiology, Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan
3 Department of Cardiology, Saka General Hospital, Shiogama, Miyagi, Japan

Because of the difficulty of predicting the response of patients with idiopathic dilated cardiomyopathy (IDC) to ß-blocker therapy, this study was performed to evaluate whether gated myocardial SPECT (gated SPECT) could be useful for predicting that response. Methods: We performed gated SPECT with 99mTc-sestamibi on 38 patients with IDC before treatment with a ß-blocker and standard medication. Perfusion abnormalities, left ventricular (LV) function, and spheric distortion were assessed by a quantitative software program. Results: We classified patients into 2 groups according to improvement in LV function after 4 mo of therapy. The groups consisted of 16 poor responders whose LV ejection fraction (LVEF) increased less than 10% and 22 good responders whose LVEF increased by 10% or more. The patient characteristics before therapy, including LV volume and LVEF, did not significantly differ between the 2 groups, but the size of the myocardial perfusion defect and spheric distortion were significantly greater in poor responders than in good responders. Conclusion: Gated SPECT, by allowing simultaneous assessment of perfusion, function and geometry, might be useful for predicting the response of patients with IDC to ß-blocker therapy.

Key Words: gated SPECT • dilated cardiomyopathy • and ß-blocker






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Copyright © 2004 by the Society of Nuclear Medicine.