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05-06-2023 | Cardiomyopathy | Original Article

Cardiac sympathetic activity and relationship to cardiac events and left ventricular reverse remodeling in patients with non-ischemic dilated cardiomyopathy

Authors: Takashi Mizutani, Ryota Morimoto, Satoshi Isobe, Ryota Ito, Takashi Araki, Yuki Kimura, Shingo Kazama, Hideo Oishi, Tasuku Kuwayama, Hiroaki Hiraiwa, Toru Kondo, Takahiro Okumura, Toyoaki Murohara

Published in: Annals of Nuclear Medicine | Issue 8/2023

Abstract

Background

Delayed heart-to-mediastinum ratio (HMR) has been associated with catecholamine levels and contractile reserve in dilated cardiomyopathy (DCM); however, there is scant evidence regarding the association between cardiac sympathetic activity and left ventricular reverse remodeling (LV-RR). We calculated the ¹²³I-metaiodobenzylguanidine (¹²³I-mIBG) HMR and washout rate (WR) in patients with DCM and investigated their associations with LV-RR.

Methods

From April 2003 to January 2020, in 120 patients with DCM who underwent ¹²³I-mIBG scintigraphy. 66 patients undergoing follow-up echo and taking a beta-blocker from baseline were examined the relationship between ¹²³I-mIBG and LV-RR. After that, this prognostic value for composite cardiac events was evaluated in the entire 120 patients.

Results

In LV-RR analysis, patients were 50.4 ± 12.2 years, with a mean left ventricular ejection fraction of 28.6%. Of 66 patients, 28 (42.4%) achieved LV-RR. Multiple logistic regression analysis of LV-RR revealed that not delayed HMR but the WR (cutoff value: 13.5%) was an independent predictor of LV-RR (odds ratio 6.514, p = 0.002). In the analysis for composite cardiac events, even though WR itself does not have the prognostic capacity, Kaplan–Meier survival curves divided by the cutoff value (delayed HMR = 2.0, WR = 13.5) showed that delayed HMR and WR values enabled the stratification of high-risk patients (log-rank p < 0.001).

Conclusions

The ¹²³I-mIBG WR was associated with the prevalence of LV-RR in patients taking 100% of beta-blockers and 98.5% of renin-angiotensin system inhibitors. Reflecting the contractile reserve, the combined assessment of the delayed HMR and WR could be used to further precisely stratify the patients with DCM.

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Title: Cardiac sympathetic activity and relationship to cardiac events and left ventricular reverse remodeling in patients with non-ischemic dilated cardiomyopathy
Authors: Takashi Mizutani
Ryota Morimoto
Satoshi Isobe
Ryota Ito
Takashi Araki
Yuki Kimura
Shingo Kazama
Hideo Oishi
Tasuku Kuwayama
Hiroaki Hiraiwa
Toru Kondo
Takahiro Okumura
Toyoaki Murohara
Publication date: 05-06-2023
Publisher: Springer Nature Singapore
Keywords: Cardiomyopathy
Scintigraphy
Heart Failure
Published in: Annals of Nuclear Medicine / Issue 8/2023
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-023-01838-9

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Cardiac sympathetic activity and relationship to cardiac events and left ventricular reverse remodeling in patients with non-ischemic dilated cardiomyopathy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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