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First published online January 21, 2009, 10.2967/jnumed.108.056341
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Journal of Nuclear Medicine Vol. 50 No. 2 220-225
© 2009 by Society of Nuclear Medicine
doi: 10.2967/jnumed.108.056341

Clinical Investigation

Myocardial β-Adrenergic Receptor Density Assessed by 11C-CGP12177 PET Predicts Improvement of Cardiac Function After Carvedilol Treatment in Patients with Idiopathic Dilated Cardiomyopathy

Masanao Naya1, Takahiro Tsukamoto1, Koichi Morita2, Chietsugu Katoh3, Kenichi Nishijima4, Hiroshi Komatsu1, Satoshi Yamada1, Yuji Kuge4, Nagara Tamaki2 and Hiroyuki Tsutsui1

1 Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 2 Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 3 Department of Health Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan; and 4 Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan

Correspondence: For correspondence or reprints contact: Masanao Naya, Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan. E-mail: naya{at}med.hokudai.ac.jp

We evaluated whether myocardial β-adrenergic receptor (β-AR) density, as determined by 11C-CGP12177 PET, could predict improvement of cardiac function by β-blocker carvedilol treatment in patients with idiopathic dilated cardiomyopathy (IDC). Methods: Ten patients with IDC (left ventricular ejection fraction [LVEF] < 45%) were studied. Myocardial β-AR density was estimated using 11C-CGP12177 PET before treatment with carvedilol. Changes of LVEF in response to dobutamine infusion ({Delta}LVEF-dobutamine) were also measured by echocardiography. Changes of LVEF ({Delta}LVEF-carvedilol) were evaluated after 20 mo of carvedilol treatment. Results: Baseline myocardial β-AR density significantly correlated with {Delta}LVEF-carvedilol (r = –0.88, P < 0.001). In contrast, {Delta}LVEF-dobutamine did not correlate with {Delta}LVEF-carvedilol (P = 0.65). Myocardial β-AR density was the significant multivariate independent predictor of {Delta}LVEF-carvedilol (β = –0.88, P < 0.001) among univariate predictors, including functional class (r = 0.76, P < 0.05), plasma norepinephrine (r = 0.85, P < 0.01), LVEF (r = –0.64, P < 0.05), and age as confounding factors. Furthermore, myocardial β-AR density was significantly correlated with plasma norepinephrine (r = –0.79, P < 0.01) and LVEF (r = 0.70, P < 0.05). Conclusion: Myocardial β-AR density is more tightly related to improvement of LVEF-carvedilol than is cardiac contractile reserve in patients with IDC. Patients with decreased myocardial β-AR have higher resting adrenergic drive, as reflected by plasma norepinephrine, and may receive greater benefit from being treated by antiadrenergic drugs.

Key Words: β-adrenergic receptor • carvedilol • 11C-CGP12177 PET • heart failure

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.


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