Late gadolinium enhancement on cardiac magnetic resonance combined with 123I- metaiodobenzylguanidine scintigraphy strongly predicts long-term clinical outcome in patients with dilated cardiomyopathy
Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is limited in its ability to detect diffuse interstitial fibrosis, which is commonly found in idiopathic dilated cardiomyopathy (DCM). On the other hand, Washout rate (WR) by cardiac 123I- metaiodobenzylguanidine (123I-MIBG) scint...
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| description | Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is limited in its ability to detect diffuse interstitial fibrosis, which is commonly found in idiopathic dilated cardiomyopathy (DCM). On the other hand, Washout rate (WR) by cardiac 123I- metaiodobenzylguanidine (123I-MIBG) scintigraphy which evaluates cardiac sympathetic nervous function, is a useful tool for predicting the prognosis in DCM. We investigated the predictive value of the combination of two different types of examinations, LGE on CMR and WR by 123I-MIBG scintigraphy for outcomes in DCM compared with LGE alone. One-hundred forty-eight DCM patients underwent CMR and 123I-MIBG scintigraphy. Patients were divided into 4 groups according to the presence or absence of LGE and WR cut-off value of 45% for predicting prognosis based on receiver operating characteristic curve analysis. Cardiac deaths, re-hospitalization for heart failure, implantation of a left ventricular assist device, and life-threatening ventricular arrhythmias were defined as clinical events. Forty-two DCM patients reached the clinical events during the median follow-up for 9.1 years (interquartile range, 8.0-9.2 years).Multivariable Cox regression analysis identified WR≥45%+LGE positive group as an independent predictor of cardiac events (HR 3.18, 95%CI 1.36-7.45, p = 0.008). Notably, there was no significance in the cardiac event-free survival rate between the WR |
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On the other hand, Washout rate (WR) by cardiac 123I- metaiodobenzylguanidine (123I-MIBG) scintigraphy which evaluates cardiac sympathetic nervous function, is a useful tool for predicting the prognosis in DCM. We investigated the predictive value of the combination of two different types of examinations, LGE on CMR and WR by 123I-MIBG scintigraphy for outcomes in DCM compared with LGE alone. One-hundred forty-eight DCM patients underwent CMR and 123I-MIBG scintigraphy. Patients were divided into 4 groups according to the presence or absence of LGE and WR cut-off value of 45% for predicting prognosis based on receiver operating characteristic curve analysis. Cardiac deaths, re-hospitalization for heart failure, implantation of a left ventricular assist device, and life-threatening ventricular arrhythmias were defined as clinical events. Forty-two DCM patients reached the clinical events during the median follow-up for 9.1 years (interquartile range, 8.0-9.2 years).Multivariable Cox regression analysis identified WR≥45%+LGE positive group as an independent predictor of cardiac events (HR 3.18, 95%CI 1.36-7.45, p = 0.008). Notably, there was no significance in the cardiac event-free survival rate between the WR<45%+LGE positive and WR≥45%+LGE negative groups (p = 0.89). The combination of WR by 123I-MIBG scintigraphy and LGE on CMR, which evaluate different type of cardiac deterioration, serves as a stronger predictor of long-term outcomes in DCM patients than LGE alone.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0217865</identifier><identifier>PMID: 31220100</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>3-Iodobenzylguanidine - administration & dosage ; Adult ; Aged ; Biology and Life Sciences ; Cardiomyopathy ; Cardiomyopathy, Dilated - diagnostic imaging ; Cardiomyopathy, Dilated - physiopathology ; Cohort Studies ; Congestive heart failure ; Contrast Media - administration & dosage ; Dilated cardiomyopathy ; Failure analysis ; Female ; Fibrosis ; Gadolinium ; Gadolinium - administration & dosage ; Growth factors ; Heart ; Heart diseases ; Heart failure ; Heart rate ; Humans ; Implantation ; Iodine ; Iodine Radioisotopes - administration & dosage ; Magnetic resonance ; Magnetic Resonance Imaging - methods ; Male ; Medical prognosis ; Medicine and Health Sciences ; Middle Aged ; Patients ; Physical Sciences ; Prognosis ; Radionuclide Imaging ; Regression analysis ; Research and Analysis Methods ; Resonance ; Scintigraphy ; Survival Rate ; Systematic review ; Treatment Outcome ; Ventricle ; Washout</subject><ispartof>PloS one, 2019, Vol.14 (6), p.e0217865-e0217865</ispartof><rights>2019 Chimura et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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On the other hand, Washout rate (WR) by cardiac 123I- metaiodobenzylguanidine (123I-MIBG) scintigraphy which evaluates cardiac sympathetic nervous function, is a useful tool for predicting the prognosis in DCM. We investigated the predictive value of the combination of two different types of examinations, LGE on CMR and WR by 123I-MIBG scintigraphy for outcomes in DCM compared with LGE alone. One-hundred forty-eight DCM patients underwent CMR and 123I-MIBG scintigraphy. Patients were divided into 4 groups according to the presence or absence of LGE and WR cut-off value of 45% for predicting prognosis based on receiver operating characteristic curve analysis. Cardiac deaths, re-hospitalization for heart failure, implantation of a left ventricular assist device, and life-threatening ventricular arrhythmias were defined as clinical events. Forty-two DCM patients reached the clinical events during the median follow-up for 9.1 years (interquartile range, 8.0-9.2 years).Multivariable Cox regression analysis identified WR≥45%+LGE positive group as an independent predictor of cardiac events (HR 3.18, 95%CI 1.36-7.45, p = 0.008). Notably, there was no significance in the cardiac event-free survival rate between the WR<45%+LGE positive and WR≥45%+LGE negative groups (p = 0.89). The combination of WR by 123I-MIBG scintigraphy and LGE on CMR, which evaluate different type of cardiac deterioration, serves as a stronger predictor of long-term outcomes in DCM patients than LGE alone.</description><subject>3-Iodobenzylguanidine - administration & dosage</subject><subject>Adult</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Dilated - diagnostic imaging</subject><subject>Cardiomyopathy, Dilated - physiopathology</subject><subject>Cohort Studies</subject><subject>Congestive heart failure</subject><subject>Contrast Media - administration & dosage</subject><subject>Dilated cardiomyopathy</subject><subject>Failure analysis</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Gadolinium</subject><subject>Gadolinium - administration & dosage</subject><subject>Growth factors</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Implantation</subject><subject>Iodine</subject><subject>Iodine Radioisotopes - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chimura, Misato</au><au>Yamada, Shinichiro</au><au>Taniguchi, Yasuyo</au><au>Yasaka, Yoshinori</au><au>Kawai, Hiroya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Late gadolinium enhancement on cardiac magnetic resonance combined with 123I- metaiodobenzylguanidine scintigraphy strongly predicts long-term clinical outcome in patients with dilated cardiomyopathy</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019</date><risdate>2019</risdate><volume>14</volume><issue>6</issue><spage>e0217865</spage><epage>e0217865</epage><pages>e0217865-e0217865</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is limited in its ability to detect diffuse interstitial fibrosis, which is commonly found in idiopathic dilated cardiomyopathy (DCM). On the other hand, Washout rate (WR) by cardiac 123I- metaiodobenzylguanidine (123I-MIBG) scintigraphy which evaluates cardiac sympathetic nervous function, is a useful tool for predicting the prognosis in DCM. We investigated the predictive value of the combination of two different types of examinations, LGE on CMR and WR by 123I-MIBG scintigraphy for outcomes in DCM compared with LGE alone. One-hundred forty-eight DCM patients underwent CMR and 123I-MIBG scintigraphy. Patients were divided into 4 groups according to the presence or absence of LGE and WR cut-off value of 45% for predicting prognosis based on receiver operating characteristic curve analysis. Cardiac deaths, re-hospitalization for heart failure, implantation of a left ventricular assist device, and life-threatening ventricular arrhythmias were defined as clinical events. Forty-two DCM patients reached the clinical events during the median follow-up for 9.1 years (interquartile range, 8.0-9.2 years).Multivariable Cox regression analysis identified WR≥45%+LGE positive group as an independent predictor of cardiac events (HR 3.18, 95%CI 1.36-7.45, p = 0.008). Notably, there was no significance in the cardiac event-free survival rate between the WR<45%+LGE positive and WR≥45%+LGE negative groups (p = 0.89). The combination of WR by 123I-MIBG scintigraphy and LGE on CMR, which evaluate different type of cardiac deterioration, serves as a stronger predictor of long-term outcomes in DCM patients than LGE alone.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31220100</pmid><doi>10.1371/journal.pone.0217865</doi><orcidid>https://orcid.org/0000-0003-3674-9171</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | 3-Iodobenzylguanidine - administration & dosage Adult Aged Biology and Life Sciences Cardiomyopathy Cardiomyopathy, Dilated - diagnostic imaging Cardiomyopathy, Dilated - physiopathology Cohort Studies Congestive heart failure Contrast Media - administration & dosage Dilated cardiomyopathy Failure analysis Female Fibrosis Gadolinium Gadolinium - administration & dosage Growth factors Heart Heart diseases Heart failure Heart rate Humans Implantation Iodine Iodine Radioisotopes - administration & dosage Magnetic resonance Magnetic Resonance Imaging - methods Male Medical prognosis Medicine and Health Sciences Middle Aged Patients Physical Sciences Prognosis Radionuclide Imaging Regression analysis Research and Analysis Methods Resonance Scintigraphy Survival Rate Systematic review Treatment Outcome Ventricle Washout |
| title | Late gadolinium enhancement on cardiac magnetic resonance combined with 123I- metaiodobenzylguanidine scintigraphy strongly predicts long-term clinical outcome in patients with dilated cardiomyopathy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T06%3A16%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Late%20gadolinium%20enhancement%20on%20cardiac%20magnetic%20resonance%20combined%20with%20123I-%20metaiodobenzylguanidine%20scintigraphy%20strongly%20predicts%20long-term%20clinical%20outcome%20in%20patients%20with%20dilated%20cardiomyopathy&rft.jtitle=PloS%20one&rft.au=Chimura,%20Misato&rft.date=2019&rft.volume=14&rft.issue=6&rft.spage=e0217865&rft.epage=e0217865&rft.pages=e0217865-e0217865&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0217865&rft_dat=%3Cproquest_plos_%3E2244362266%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2244362266&rft_id=info:pmid/31220100&rft_doaj_id=oai_doaj_org_article_6eb7662ef1d04351a732a2f98639376d&rfr_iscdi=true |