| Japanese |
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| Title | 拡張型心筋症の予後評価における123I-metaiodobenzylguanidineの有用性 |
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| Subtitle | 原著 |
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| Authors | 鈴木康*, 外山卓二*, 神田享勉*, 塚越譲一*, 磯部直樹*, 長岡秀樹*, 久保田幸夫*, 飯塚利夫*, 今井進*, 永井良三*, 舘野円**, 遠藤啓吾**, 鈴木忠*** |
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| Authors(kana) | |
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| Organization | *群馬大学医学部第二内科, **核医学科, ***群馬大学医療技術短期大学部 |
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| Journal | 核医学 |
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| Volume | 32 |
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| Number | 11 |
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| Page | 1207-1215 |
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| Year/Month | 1995/11 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」拡張型心筋症(DCM)の予後評価における123I-MIBG心筋シンチグラフィの有用性を検討した. 対象はDCM 17例で, 5年間の経過中にcardiac event(CE)を合併したA群9例(心死亡4例, 心不全入院6例, 心室性頻拍症5例)と合併しないB群8例である. 観察開始時に施行した安静時(R)Tl SPECTと安静時早期(E)および3時間後(3h)のMIBG SPECTをそれぞれ20区域に分割し, 集積程度をdefect score(DS)の4段階(0:正常〜3:欠損)で評価し, 20区域のDS合計(TDS)を求めた. TDSおよび同時期の心エコー図での拡張末期左室径/体表面積(LVDd/BSA), 収縮末期左室径/体表面積(LVDs／BSA), 左室駆出率(EF)および肺動脈楔入圧(PAWP), NYHA機能分類をA, B群間で比較した. A群はB群に比し, 3h-MIBG像のTDS(p<0.001), およびE-MIBG像のTDS(p<0.05), R-Tl像のTDS(p<0.01), LVDd/BSA(p<0.01), LVDs/BSA(p<0.001), NYHA機能分類(p<0.05)で有意に高値で, EF(p<0.01)は低値を示した. 多変量解析によるCEの関連因子の検討では, 3h-MIBG像のTDS(p<0.001), PAWP(p=0.0124), LVDd/BSA(p=0.0026)が有用であった. DCMのcardiac eventの予後評価に123I-MIBG後期像が有用であった. |
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| Practice | 臨床医学：一般 |
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| Keywords | 123I-MIBG, DCM, Prognosis. |
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| English |
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| Title | Prognostic Significance of 123I-Metaiodobenzylguanidine Scintigraphy in Dilated Cardiomyopathy |
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| Authors | Yasushi SUZUKI*, Takuji TOYAMA*, Tsugiyasu KANDA*, Jouichi TSUKAGOSHI*, Naoki ISOBE*, Hideki NAGAOKA*, Sachio KUBOTA*, Toshio IIZUKA*, Susumu IMAI*, Ryozo NAGAI*, Madoka TATENO**, Keigo ENDO**, Tadashi SUZUKI*** |
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| Authors(kana) | |
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| Organization | *Second Department of Internal Medicine, Gunma University School of Medicine, **Department of Nuclear Medicine, Gunma University School of Medicine, ***The School of Allied Medical Professions, Gunma University |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 32 |
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| Number | 11 |
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| Page | 1207-1215 |
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| Year/Month | 1995/11 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]The prognostic factor was identified by performing 123I-Metaiodobenzylguanidine (MIBG) myocardial scintigraphy on 17 patients with dilated cardiomyopathy (DCM). During 5 years period, 9 patients had cardiac events, four of whom died, six were admitted due to heart failure and five had ventricular tachycardiac events. At the starting point, we collected rest early and 3-hr-delayed MIBG SPECT along with rest 201Tl (Tl) SPECT. In the SPECT, regional tracer uptake was scored using 4-grades defect score(0=normal to 3=uptake-defect), and summed up to total defect score (TDS). At the same time, we estimated left ventricular end-diastolic dimension/body surface area (LVDd/BSA), end-systolic dimension/body surface area (LVDs/BSA) and left ventricular ejection fraction (LVEF) by echo-cardiography, pulmonary arterial wedge pressure (PAWP) and New York Heart Association (NYHA) symptom class. We compared the clinical and hemodynamic parameters between the patients with cardiac events (group A) and the other patients (group B). TDS of delayed MIBG SPECT (p<0.001), TDS of early MIBG SPECT (p<0.05), TDS of Tl SPECT (p<0.01), LVDd/BSA (p<0.01), LVDs/BSA (p<0.001) and NYHA class (p<0.05) of group A were significantly larger than those of group B. But, LVEF of group A was significantly less than that of group B (p<0.01). On multivariate analysis, the following parameters were independent predictors of cardiac events : TDS of delayed MIBG SPECT (p<0.001), PAWP (p=0.0124) and LVDd/BSA (p=0.0026). These data suggest that delayed MIBG scintigraphy is thought to be important to predict cardiac events in patients with DCM. |
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| Practice | Clinical medicine |
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| Keywords | 123I-MIBG, DCM, Prognosis. |
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