PT - JOURNAL ARTICLE AU - Shu Kasama AU - Takuji Toyama AU - Hisao Kumakura AU - Yoshiaki Takayama AU - Shuichi Ichikawa AU - Shoichi Tange AU - Tadashi Suzuki AU - Masahiko Kurabayashi TI - Dobutamine Stress <sup>99m</sup>Tc-Tetrofosmin Quantitative Gated SPECT Predicts Improvement of Cardiac Function After Carvedilol Treatment in Patients with Dilated Cardiomyopathy DP - 2004 Nov 01 TA - Journal of Nuclear Medicine PG - 1878--1884 VI - 45 IP - 11 4099 - http://jnm.snmjournals.org/content/45/11/1878.short 4100 - http://jnm.snmjournals.org/content/45/11/1878.full SO - J Nucl Med2004 Nov 01; 45 AB - We evaluated whether dobutamine stress 99mTc-tetrofosmin quantitative gated SPECT (D-QGS) could predict improvement of cardiac function by carvedilol therapy in patients with dilated cardiomyopathy (DCM). Methods: The study included 30 patients with idiopathic DCM and a left ventricular ejection fraction (LVEF) of &lt;45%. D-QGS was performed in all patients to measure LVEF at rest and during dobutamine infusion (10 μg/kg/min). LVEF and left ventricular end-diastolic volume (LVEDV) were determined by echocardiography, plasma brain natriuretic peptide (BNP) was measured, and the New York Heart Association (NYHA) functional class was estimated at baseline and after 1 y of combined treatment with an angiotensin-converting enzyme (ACE) inhibitor, diuretic, and the β-blocker carvedilol. After treatment, the echocardiographic LVEF improved by &gt;5% in 15 patients (group A) but did not improve in the remaining 15 patients (group B). Results: The baseline LVEF, LVEDV, plasma BNP, and NYHA functional class were similar in both groups. However, there was a greater increase of LVEF (ΔLVEF) with dobutamine infusion during D-QGS in group A than that in group B (12.0% ± 5.8% vs. 2.7% ± 4.2%, P &lt; 0.0001). When a cutoff value of 6.6% for ΔLVEF was used to predict the improvement of LVEF by carvedilol therapy, the sensitivity was 86.7%, the specificity was 86.7%, and the accuracy was 86.7%. LVEDV, plasma BNP, and NYHA functional class all showed superior improvement in group A compared with group B. Conclusion: ΔLVEF measured by D-QGS was significantly larger in patients who responded to carvedilol than that in nonresponders. These findings indicate that D-QGS can be used to predict improvement of cardiac function and heart failure symptoms by carvedilol therapy in patients with idiopathic DCM.