| Japanese |
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| Title | 拡張型心筋症に対するβ-blocker療法の効果予測における123I-MIBG心筋シンチグラムの有用性 |
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| Subtitle | 原著 |
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| Authors | 俵原敬*, 杉山壮*, 仲野友康*, 間遠文貴*, 倉田千弘**, 若林康**, 正田栄**, 三上直** |
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| Organization | *浜松赤十字病院内科, **浜松医科大学第三内科 |
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| Journal | 核医学 |
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| Volume | 35 |
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| Number | 6 |
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| Page | 413-420 |
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| Year/Month | 1998/7 |
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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」拡張型心筋症においてβ-blocker療法を行う際, その有効性を予測するのに123I-MIBG心筋シンチグラムが有用であるかについて検討した. 対象はβ-blocker療法前に123I-MIBG心筋シンチグラムを施行した拡張型心筋症群9例と正常コントロール群11例. β-blocker療法前の123I-MIBG心筋シンチグラム上, 拡張型心筋症群で正常コントロール群に比し, 初期像と後期像の心/縦隔比は有意な低値を認め, washout rate では有意な亢進を認めた. また拡張型心筋症群9例中β-blocker療法により心エコー上左室駆出率の改善した群は7例(改善群), 左室駆出率が悪化した群は2例(悪化群, 2例とも心不全が悪化し死亡)であった. β-blocker療法前の123I-MIBG心筋シンチグラムにおいて, washout rate は悪化群で改善群に比し有意な亢進を認め(45±8% vs. 30±3%, p<0.05), 123I-MIBG心筋シンチグラム上著明な washout rate の亢進を認める拡張型心筋症の症例では, β-blocker療法により悪化する危険性があることが示唆された. 他方, 心エコーの左室駆出率および初期像と後期像の心/縦隔比は, いずれも改善群と悪化群との間で有意差を認めなかった. 以上より, 123I-MIBG心筋シンチグラム上の washout rate は拡張型心筋症におけるβ-blocker療法の有効性の予測の指標として有用である可能性が示された. |
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| Practice | 臨床医学：一般 |
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| Keywords | Dilated cardiomyopathy, β-blocker therapy, MIBG |
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| English |
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| Title | Usefulness of 123I-MIBG Scintigraphy for Prediction of Effect of β-Blocker Therapy in Dilated Cardiomyopathy |
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| Subtitle | Original Articles |
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| Authors | Kei TAWARAHARA*, Tsuyoshi SUGIYAMA*, Tomoyasu NAKANO*, Fumitaka MATOU*, Chinori KURATA**, Yasushi WAKABAYASHI**, Sakae SHOUDA**, Tadashi MIKAMI** |
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| Authors(kana) | |
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| Organization | *Department of Internal Medicine, Hamamatsu Red Cross Hospital, **Department of Internal Medicine III, Hamamatsu University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 35 |
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| Number | 6 |
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| Page | 413-420 |
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| Year/Month | 1998/7 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | To determine whether 123I-MIBG (MIBG) scintigraphy is useful for predicting the effect of β-blocker therapy in patients with dilated cardiomyopathy (DCM), we studied MIBG scintigraphy in 11 controls and 9 patients with DCM before starting β-blocker therapy. First, initial and delayed heart-to-mediastinum ratios (H/M ratio) of MIBG activity in patients with DCM were significantly lower than those in 11 controls, respectively (initial H/M; 1.8 +- 0.3 vs. 2.1 +- 0.3, p < 0.02, delayed H/M; 1.6 +- 0.3 vs. 2.4 +- 0.2, p < 0.0001), and MIBG washout rate from the heart was significantly higher in patients than in controls (washout rate; 33 +- 7% vs. 22 +- 4%, p < 0.0005). Second, β-blocker therapy improved LVEF in 7 patients (improved group), while it resulted in deterioration of heart failure, followed by death in 2 patients (deteriorated group). Although initial and delayed H/M ratios in the improved group were not significantly different from those in the deteriorated group, respectively, MIBG washout rate was significantly higher in the deteriorated group than in the improved group (45 +- 8% vs. 30 +- 3%, p = 0.04). Our study suggests that DCM patients with markedly rapid MIBG clearance may be deteriorated by β-blocker therapy. In contrast, there were no differences in LVEF and plasma norepinephrine between improved and deteriorated groups. In conclusion, 123I-MIBG scintigraphy is useful for predicting the effects of β-blocker therapy in patients with DCM. |
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| Practice | Clinical medicine |
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| Keywords | Dilated cardiomyopathy, β-blocker therapy, MIBG |
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