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  • Title: Myocardial contractile reserve determined by dobutamine stress Tc-99m tetrofosmin quantitative gated SPECT predicts late spontaneous improvement in cardiac function in patients with recent-onset dilated cardiomyopathy.
    Author: Kasama S, Toyama T, Kumakura H, Takayama Y, Ichikawa S, Suzuki T, Kurabayashi M.
    Journal: J Nucl Cardiol; 2003; 10(6):607-14. PubMed ID: 14668772.
    Abstract:
    BACKGROUND: We evaluated whether dobutamine stress technetium 99m tetrofosmin (DSTF) quantitative gated single photon emission computed tomography (QGS) could predict late spontaneous improvement of cardiac function in patients with idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS: The study included 26 patients with recently diagnosed (<2 months) idiopathic DCM and a left ventricular ejection fraction (LVEF) lower than 45%. DSTF-QGS was performed in all patients to measure LVEF at rest and during dobutamine infusion (10 microg. kg(-1). min(-1)). LVEF and left ventricular end-diastolic volume (LVEDV) were determined by echocardiography, and New York Heart Association (NYHA) functional class was estimated at baseline and after 1 year. After 1 year of treatment, the echocardiographic LVEF improved by greater than 5% in 13 patients (group A) but did not improve in the remaining 13 patients (group B). At baseline, the echocardiographic LVEF, LVEDV, and NYHA functional class were similar in both groups. However, there was a greater increase in the LVEF during the dobutamine infusion portion of the DSTF-QGS (DeltaLVEF) in group A than in group B (13.1% +/- 5.9% vs 2.6% +/- 4.1%, P <.0001). If a critical value for the DeltaLVEF of 7.0% was used to predict improvement in LVEF after treatment, the sensitivity was 84.7% and the specificity was 84.7%. LVEDV and NYHA functional class improved to a greater extent in group A than in group B. CONCLUSIONS: DSTF-QGS can be used to predict late spontaneous improvement in cardiac function and symptoms after treatment in patients with idiopathic DCM.
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