Myocardial positron emission computed tomographic images obtained with fluorine-18 fluoro-2-deoxyglucose predict the response of idiopathic dilated cardiomyopathy patients to beta-blockers.
OBJECTIVE
The aim of this study was to elucidate whether the response of idiopathic dilated cardiomyopathy (DCM) patients to beta-blockers can be predicted by positron emission tomography with fluorine-18 fluoro-2-deoxyglucose (FDG-PET).


BACKGROUND
Patients with DCM often have a poor prognosis, and it is important to predict their response to beta-blocker therapy, which may be effective in DCM. However, no accurate methods of predicting their response have been available.


METHODS
In 22 DCM patients with reduced left ventricular (LV) systolic function, FDG-PET was performed. Uptake in the LV after glucose loading was evaluated based on the average global percent uptake of the injected dose (G%ID) and the coefficient of variance (CV) in 24 segments of the LV. Uptake during fasting was evaluated semiquantitatively on the basis of the total uptake score. The beta-blocker was administered, and LV function was monitored by echocardiography. The histologic findings were assessed in the 18 patients who underwent endomyocardial biopsy.


RESULTS
The beta-blocker was effective in the majority of patients whose G%ID after glucose loading was >0.7%, and the sensitivity and specificity of G%ID as a predictor of beta-blocker efficacy were 83.3% and 90.0%, respectively. Percent CV did not predict efficacy. Four groups, defined on the basis of the FDG uptake score during fasting and G%ID after glucose loading, had distinctive histologic findings and outcomes.


CONCLUSIONS
It has been shown that FDG-PET is a good predictor for the effectiveness of beta-blockers.
Hasegawa
Shinji
S
Department of Tracer Kinetics and Nuclear Medicine, Osaka University Graduate School of Medicine, Suita, Japan. gasegawa@tracer.med.osaka-u.ac.jp
Kusuoka
Hideo
H
Maruyama
Kaoru
K
Nishimura
Tsunehiko
T
Hori
Masatsugu
M
Hatazawa
Jun
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006334:Heart Function Tests / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18