Prediction of adverse cardiac events in dilated cardiomyopathy using cardiac T2* MRI and MIBG scintigraphy

Michinobu Nagao, Shingo Baba, Masato Yonezawa, Yuzo Yamasaki, Takeshi Kamitani, Takuro Isoda, Satoshi Kawanami, Yasuhiro Maruoka, Yoshiyuki Kitamura, Kohtaro Abe, Taiki Higo, Kenji Sunagawa, Hiroshi Honda

研究成果: Contribution to journalArticle査読

9 被引用数 (Scopus)

抄録

Iron deficiency and cardiac sympathetic impairment play a role in the worsening of heart failure, and these two conditions may be linked. The present study aimed to clarify the relationship between myocardial iron deficiency, cardiac sympathetic activity, and major adverse cardiac events (MACE) in patients with dilated cardiomyopathy (DCM). Cardiac T2* MRI for iron deficiency and 123I-Metaiodobenzylguanidine (MIBG) imaging for cardiac sympathetic activity were performed in 46 patients with DCM. Myocardial T2* value (M-T2*) was calculated by fitting signal intensity data for mid-left ventricular septum to a decay curve using 3-Tesla scanner. 123I-MIBG washout rate (MIBG-WR) was calculated using a polar-map technique with tomographic data. We analyze the ability of M-T2* and MIBG-WR to predict MACE. MIBG-WR and M-T2* were significantly greater in DCM patients with MACE than in patients without MACE. Receiver-operating-characteristics curve analysis showed that the optimal MIBG-WR and M-T2* thresholds of 35 % and 28.1 ms, and the two combination predict MACE with C-statics of 0.69, 0.73, and 0.82, respectively. Patients with MIBG-WR <35 % and M-T2* <28.1 ms had significantly lower event-free rates than those with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (log-rank value = 4.35, p < 0.05). Cox hazard regression analysis showed that χ2 and the hazard ratio were 3.99 and 2.15 for development of MACE in patients with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (p < 0.05). Iron deficiency, expressed by a high M-T2*, and MIBG-WR were both independent predictors of MACE in patients with DCM. The two combination was a more powerful predictor of MACE than either parameter alone.

本文言語英語
ページ(範囲)399-407
ページ数9
ジャーナルInternational Journal of Cardiovascular Imaging
31
2
DOI
出版ステータス出版済み - 2 27 2015

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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