^(123)Ⅰ-MIBG心肌显像评价扩张型心肌病心力衰竭的严重程度及预后

^(123)Ⅰ-MIBG Myocardial Imaging for the Assessment of Severity and Prognosis in Patients with Dilated Cardiomyopathy with Heart Failure

目的 探讨 1 2 3 Ⅰ MIBG心肌显像在评价扩张型心肌病心力衰竭 (DCM HF)的严重程度及其预后中的应用价值。方法 对 2 4例DCM HF患者 (DCM HF组 )和 1 0例正常者 (NC组 ) ,行早期 (2 0min)及延迟 (3h) 1 2 3 Ⅰ MIBG心肌显像 ,采用心 /上纵隔 (H/M)和心脏放射性洗脱率 (WR % )作为相对半定量计数分析 ,与超声心功能指标及血浆去甲肾上腺素 (NE)浓度进行对比。结果 DCM HF组的早期及延迟H/M均低于NC组 ,WR均高于NC组。NYHA心功能Ⅳ级患者延迟H/M低于Ⅱ级患者。DCM HF组的H/M与左室射血分数呈正相关 (早期相r=0 .5 81 ,P <0 .0 1 ;延迟相r=0 .6 99,P <0 .0 1 ) ,而WR与左室射血分数呈负相关 (r=- 0 .6 2 8,P <0 .0 5 )。延迟H/M与血浆NE浓度呈负相关 (r=- 0 .5 0 7,P <0 .0 5 ) ,而WR与血浆NE浓度呈正相关 (r=0 .4 79,P <0 .0 5 )。结论 1 2 3 Ⅰ MIBG心肌显像可用于评价DCM

Objective To investigate the clinical appolication value of 123 Ⅰ MIBG myocardial imaging to assess the severity and prognosis in patients with dilated cardiomyopathy with heart failure (DCM HF). Methods 123 Ⅰ MIBG myocardial imaging was applied to 24 cases of DCM HF and 10 healthy volunteers,compared with B ultrasound and plasma concentrations of norepinephrine (NE). Results The Heart/mediatinum uptake ratio (H/M) of MIBG were decreased in early and delay images,and washout rate (WR) were increased in DCM HF respectively.The delay H/M was significantly decreased in the patients with NYHA class Ⅳ than the patients with NYHA class Ⅱ.A significant correlation was found between left ventricular ejection fraction and H/M (r=0.581,P<0.01,on early images;r=0.699,P<0.01,on delay images),and WR (r=-0.628,P<0.05) in the patients with DCM HF.On the otherhand,a significant correlation was found between plasma concentrations of NE and H/M on delay images (r=-0.507,P<0.05) and WR (r=0.479,P<0.05) in the patients with DCM HF. Conclusion This findings indicate that 123 Ⅰ MIBG myocardial imaging may assess the severity and prognosis in the patients with DCM HF.