Dilated cardiomyopathy relieved as a result of beta-blocker therapy: a case report--key points in assessment of prognosis based on MIBG myocardial scintigraphy and BNP levels.
A 48-year-old male patient was admitted to our hospital with dyspnea accompanied by orthopnea. Chest x-rays showed a cardiothoracic ratio of 68% and pulmonary congestion. He was diagnosed with dilated cardiomyopathy. Beta-Blocker (carvedilol) therapy was initiated on Day 22 of the disease using a small initial dose. He was followed up based on BNP levels and MIBG scintigraphy. The H/M ratio and MIBG washout rate were 1.98 and 33.4%, respectively, on Day 20 and 2.15 and 28.1%, respectively, on Day 72. The patient was discharged on Day 72 when congestive heart failure improved. Relatively high BNP levels were observed for 1 month after starting treatment with a beta-blocker. Plasma BNP levels were still as high when his heart failure was improved. BNP is useful as a convenient indicator for the severity of cardiac diseases. MIBG scintigraphy may be used thereafter to evaluate the severity in greater detail and more precisely determine the prognosis.
Matsuo
Shinro
S
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta, Otsu, Japan. smatsuo@belle.shiga-med.ac.jp
Nakae
Ichiro
I
Masuda
Daisuke
D
Matsumoto
Tetsuya
T
Horie
Minoru
M
D019797:3-Iodobenzylguanidine; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy*; D000077261:Carvedilol; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D011412:Propanolamines / Q000627:therapeutic use*; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D019275:Radiopharmaceuticals; D000077261:Carvedilol; D020097:Natriuretic Peptide, Brain; D019797:3-Iodobenzylguanidine