OtherCLINICAL INVESTIGATIONS

Recovery of the Cardiac Adrenergic Nervous System After Long-Term β-Blocker Therapy in Idiopathic Dilated Cardiomyopathy: Assessment by Increase in Myocardial 123I-Metaiodobenzylguanidine Uptake

Ulrich Lotze, Stefan Kaepplinger, Andreas Kober, Barbara M. Richartz, Dietmar Gottschild and Hans R. Figulla
Journal of Nuclear Medicine January 2001, 42 (1) 49-54;

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    123I-MIBG images obtained from short-axis reconstruction in patient with IDC. The M/C ratio reflecting myocardial 123I-MIBG uptake increased from 2.4 before treatment to 3.6 after treatment with β-blocker (bisoprolol) for about 1 y. C = left ventricular cavity; M = myocardium.

  • FIGURE 2.
    FIGURE 2.

    Changes in 123I-MIBG M/C ratio (A), LVEF (B), LVEDD (C), and New York Heart Association (NYHA) functional class (D) under β-blocker therapy for 1 y. Individual data points for each patient and mean values ± SD of four parameters measured at entry and after 1 y of treatment with β-blockers are shown.

  • FIGURE 3.
    FIGURE 3.

    Individual course of LVEF and M/C ratio of patients shows good relationship between changes in LVEF (LVEF at follow-up examination − LVEF at baseline) and 123I-MIBG M/C ratio after 1 y of therapy with β-blockers. In one patient (*), LVEF remained unchanged at 40%, and M/C ratio only increased from 3.12 to 3.18. In another patient (**), LVEF showed small decrease in LVEF from 35% to 30% and in M/C ratio from 2.26 to 2.17. In the remaining eight patients, ascending lines indicate simultaneous increase in LVEF and in M/C ratio.

Tables

  • TABLE 1.

    Clinical Baseline Characteristics and Hemodynamic Parameters

    Parametern
    No. of patients (men)10 (9)
    Age (y), mean ± SD51 ± 8
    NYHA functional class
     I2
     II4
     III4
    Medication
     ACE inhibitors9
     AT type 1 receptor antagonists1
     Diuretics6
     Digitalis7
     β-Blockers10
    LVEF (echo) (%)
     Mean ± SD30 ± 7
     Range17–40
    LVEDD (echo) (mm)
     Mean ± SD67 ± 7
    Follow-up (mo)
     Mean ± SD13 ± 3
     Range8–18
     Median11.5

    • NYHA = New York Heart Association; AT = angiotensin II; echo = echocardiographic.

  • TABLE 2.

    One-Year Follow-Up Under β-Blocker Therapy

    Patients with IDC (n = 10)Pretreatment (mean ± SD)Posttreatment (mean ± SD)Average difference ± SDP
    M/C ratio2.21 ± 0.622.72 ± 0.690.51 ± 0.460.005
    LVEF (echo) (%)30 ± 742 ± 712.4 ± 10.80.005
    LVEDD (echo) (mm)67 ± 762 ± 2−5.2 ± 5.80.019
    NYHA functional class
     I26—
     II43—0.139
     III41—

    • Echo = echocardiographic; NYHA = New York Heart Association.

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