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Heart and Vessels

, Volume 34, Issue 2, pp 259–267 | Cite as

Very long-term follow-up data of non-ischemic idiopathic dilated cardiomyopathy after beta-blocker therapy: recurrence of left ventricular dysfunction and predictive value of 123I-metaiodobenzylguanidine scintigraphy

  • Shunsuke Nishimura
  • Chisato IzumiEmail author
  • Yoshihiro Himura
  • Maiko Kuroda
  • Masashi Amano
  • Takeshi Harita
  • Suguru Nishiuchi
  • Jiro Sakamoto
  • Yodo Tamaki
  • Soichiro Enomoto
  • Makoto Miyake
  • Toshihiro Tamura
  • Hirokazu Kondo
  • Yoshihisa Nakagawa
Original Article
  • 87 Downloads

Abstract

The management of idiopathic dilated cardiomyopathy (DCM) is well established. However, a subset of patients do not have recovery from or have recurrences of left ventricular (LV) dysfunction despite receiving optimal medical therapy. There are limited long-term follow-up data about LV function and the predictive value of iodine-123-metaiodobenzylguanidine (123I-MIBG) scintigraphy, especially among the Japanese population. We retrospectively investigated 81 consecutive patients with DCM (mean LV ejection fraction (EF) 28 ± 7.5%) who had undergone 123I-MIBG scintigraphy before starting β-blockers. According to chronological changes in LVEF, study patients were classified into three subgroups: sustained recovery group, recurrence group, and non-recovery group. The outcome measure was cardiac death. Mean age was 59 ± 11 years and median follow-up was 11.5 (5.8–15.0) years. Thirty-six patients had recovery, 11 had recurrences, and 34 did not have recovery. The sustained recovery group had the best cardiac death-free survival, followed by the recurrence and non-recovery groups. Prolonged time to initial recovery was associated with recurrence of LV dysfunction. Large LV end-diastolic diameter and reduced heart to mediastinum ratio were associated with poor prognosis. In conclusion, with β-blocker therapy, 14% of patients showed recurrences of LV dysfunction. Thus, careful follow-up is needed, keeping in mind the possibility of recurrence, even if LVEF once improved, especially in patients whose time to initial recovery was long. 123I-MIBG scintigraphy provides clinicians with additional prognostic information.

Keywords

123I-MIBG scintigraphy Dilated cardiomyopathy β-Blocker Prognosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Shunsuke Nishimura
    • 1
  • Chisato Izumi
    • 1
    Email author
  • Yoshihiro Himura
    • 2
  • Maiko Kuroda
    • 1
  • Masashi Amano
    • 1
  • Takeshi Harita
    • 1
  • Suguru Nishiuchi
    • 1
  • Jiro Sakamoto
    • 1
  • Yodo Tamaki
    • 1
  • Soichiro Enomoto
    • 1
  • Makoto Miyake
    • 1
  • Toshihiro Tamura
    • 1
  • Hirokazu Kondo
    • 1
  • Yoshihisa Nakagawa
    • 1
  1. 1.Department of CardiologyTenri HospitalTenriJapan
  2. 2.Department of Cardiovascular MedicineHikone Municipal HospitalHikoneJapan

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