Japanese
Title心不全における123I-BMIPP心筋イメージング - その予後評価における有用性 : 非虚血性心疾患での検討 -
Subtitle原著
Authors成田充啓*, 栗原正*, 新藤高士*, 澤田善博*, 本田稔**
Authors(kana)
Organization*住友病院循環器科, **住友病院放射線科 (アイソトープ室)
Journal核医学
Volume35
Number4
Page229-237
Year/Month1998/4
Article原著
Publisher日本核医学会
Abstract「要旨」冠動脈狭窄のない心不全(CHF)での心筋脂肪酸代謝の予後評価における有用性を検討するため, 健常(N)15例, CHF42例で123I-BMIPP(PP), 201Tl(Tl)心筋イメージング(I)を施行した. CHFの基礎疾患は特発性心筋症24例, 高血圧性心疾患12例, 弁膜症6例である. PP, Tlの心筋への取り込み率(%PP, %Tl)の取り込み比(UR, %PP/%Tl), PPの洗い出し率(%WO)や心筋内分布の不均一性(CV)を求めた. CHFではNに比し%PP, %Tl, CVの亢進, URの低下(0.91±0.16 vs. 1.01±0.09, p=0.0000)を見たが%WOは差を見なかった. CHFは27.4±14.4か月(4.5-53.5か月)フォローアップ, 15例(36%)で心事故が出現した(心臓死8, CHFの増悪7). 単変量解析では心事故群, 無事故群で%Tl, UR, NYHA class, %FS, 血中ノルエピネフリン濃度, レニン活性に有意差を見たが, 多変量解析で心事故の出現を予測しうる独立した因子はURと年齢のみであった. ことにUR≦0.88で心事故出現の相対リスクはUR≧0.89の23.7倍であった. 以上の結果はCHFの予後評価にPP-Iが有用であることを示唆した.
Practice臨床医学：一般
Keywords123I-BMIPP, Congestive heart failure, Prognosis, Uptake ratio
English
TitlePrognostic Value of Myocardial 123I-BMIPP Imaging in Patients with Congestive Heart Failure without Coronary Artery Disease
SubtitleOriginal Articles
AuthorsMichihiro NARITA*, Tadashi KURIHARA*, Takashi SINDOH*, Yoshihiro SAWADA*, Minoru HONDA**
Authors(kana)
Organization*Department of Cardiology, Sumitomo Hospital, **Department of Radiology, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume35
Number4
Page229-237
Year/Month1998/4
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractWe performed 123I-BMIPP (BMIPP) imaging in order to clarify the characteristics of fatty acid metabolism and its effect on prognosis in patients with congestive heart failure (CHF) without coronary artery disease. We studied 15 normal subjects and 42 patients with CHF (idiopathic dilated cardiomyopathy; 24, hypertensive heart disease; 12, valvular heart disease; 6). We obtained cardiac imaging with BMIPP and 201Tl at rest on separate days before discharge. Using whole body imaging, the ratio of cardiac uptake of the isotope to total injected dose was calculated (%Uptake). We calculated the cardiac uptake ratio of BMIPP (%Uptake of BMIPP divided by %Uptake of 201Tl), percent washout of BMIPP from the heart over 3 hours and unhomogeneity of myocardial distribution of BMIPP (coefficient of variation of BMIPP, CV) as scintigraphic parameters. Cardiac events were defined as cardiac death or deterioration of CHF which requiring readmission. Uptake ratio (CHF: 0.91 +- 0.17, normal; 1.10 +- 0.09, p = 0.0000) and CV (CHF; 20 +- 5, normal; 16 +- 5, p = 0.0385) were different significantly between CHF and normal subjects. During the follow-up period of 27.2 +- 14.4 months (4.5 - 53.5 months) cardiac events developed in 15 patients (cardiac death; 8, deterioration of CHF; 7). In univariate analysis, %uptake of 201Tl, uptake ratio, %FS, serum norepinephrine level and serum renin activity were different significantly between event and event-free groups. Cox proportional hazard analysis showed that the uptake ratio (p = 0.0000) and age (p = 0.018) were independent predictors of cardiac events. In patients with uptake ratio less than 0.88, relative risks of cardiac events was 23.7 times greater than in patients with uptake ratio more than 0.89. These data suggested that in patients with CHF fatty acid metabolism was deteriorated and cardiac uptake of BMIPP was a strong and independent predictor of long-term prognosis in patients with heart failure.
PracticeClinical medicine
Keywords123I-BMIPP, Congestive heart failure, Prognosis, Uptake ratio

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