PMID- 15534058
OWN - NLM
STAT- MEDLINE
DCOM- 20050111
LR  - 20191210
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 45
IP  - 11
DP  - 2004 Nov
TI  - Dobutamine stress 99mTc-tetrofosmin quantitative gated SPECT predicts improvement 
      of cardiac function after carvedilol treatment in patients with dilated 
      cardiomyopathy.
PG  - 1878-84
AB  - We evaluated whether dobutamine stress (99m)Tc-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 
      <45%. D-QGS was performed in all patients to measure LVEF at rest and during 
      dobutamine infusion (10 microg/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 beta-blocker 
      carvedilol. After treatment, the echocardiographic LVEF improved by >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 (Delta 
      LVEF) with dobutamine infusion during D-QGS in group A than that in group B 
      (12.0% +/- 5.8% vs. 2.7% +/- 4.2%, P < 0.0001). When a cutoff value of 6.6% for 
      Delta LVEF 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: Delta LVEF 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.
FAU - Kasama, Shu
AU  - Kasama S
AD  - Department of Cardiovascular Medicine, Gunma University School of Medicine, 
      Maebashi, Gunma 971-0034, Japan. s-kasama@bay.wind.ne.jp
FAU - Toyama, Takuji
AU  - Toyama T
FAU - Kumakura, Hisao
AU  - Kumakura H
FAU - Takayama, Yoshiaki
AU  - Takayama Y
FAU - Ichikawa, Shuichi
AU  - Ichikawa S
FAU - Tange, Shoichi
AU  - Tange S
FAU - Suzuki, Tadashi
AU  - Suzuki T
FAU - Kurabayashi, Masahiko
AU  - Kurabayashi M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Validation Study
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Carbazoles)
RN  - 0 (Propanolamines)
RN  - 0K47UL67F2 (Carvedilol)
RN  - 3S12J47372 (Dobutamine)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Adult
MH  - Aged
MH  - Carbazoles/*therapeutic use
MH  - Cardiomyopathy, Dilated/*diagnostic imaging/*drug therapy
MH  - Carvedilol
MH  - *Dobutamine
MH  - Exercise Test/methods
MH  - Female
MH  - Gated Blood-Pool Imaging/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Propanolamines/*therapeutic use
MH  - Recovery of Function/physiology
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Tomography, Emission-Computed, Single-Photon/*methods
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*diagnostic imaging/*drug therapy/etiology
EDAT- 2004/11/10 09:00
MHDA- 2005/01/12 09:00
CRDT- 2004/11/10 09:00
PHST- 2004/11/10 09:00 [pubmed]
PHST- 2005/01/12 09:00 [medline]
PHST- 2004/11/10 09:00 [entrez]
AID - 45/11/1878 [pii]
PST - ppublish
SO  - J Nucl Med. 2004 Nov;45(11):1878-84.