Prognostic value of cardiac I-123 metaiodobenzylguanidine imaging in patients with non-insulin-dependent diabetes mellitus.
BACKGROUND
123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for diagnosing cardiac autonomic neuropathy (CAN) in non-insulin-dependent diabetes mellitus (NIDDM). However, the long-term prognostic value for cardiac events or mortality in NIDDM has not been clarified.


RESULTS
We investigated the long-term prognostic value of cardiac MIBG imaging for both cardiac event and mortality owing to a variety of causes of death in NIDDM. 144 NIDDM patients were analyzed retrospectively with the end-points of a cardiac event and various causes of mortality. The heart-to-mediastinum uptake ratio on the delayed image (H/M [d]) was obtained from anterior planar imaging. The mean follow-up period was 7.2+/-3.2 years. Seventeen patients had a cardiac event onset and 7 patients died during observation. During the same observation course, 16 patients died, including some who died of cardiac event. Both multivariate and univariate analyses revealed that decreased H/M (d) (<1.7) was the independent predictor of long-term mortality for a variety of causes of death. Although the value of H/M (d) was not a significant prognostic factor for predicting a cardiac event, CAN, diagnosed by a combination of H/M (d) and coefficient variance of RR interval, was an independent predictor for the cardiac event in NIDDM.


CONCLUSIONS
MIBG myocardial scintigraphy was useful for predicting cardiac events and long-term mortality in NIDDM.
Nagamachi
Shigeki
S
Department of Radiology, Miyazaki Medical College, Miyazaki, Japan. snagama@med.miyazaki-u.ac.jp
Fujita
Seigo
S
Nishii
Ryuichi
R
Futami
Shigemi
S
Tamura
Shozo
S
Mizuta
Masanari
M
Nakazato
Masamitsu
M
Kurose
Takeshi
T
Wakamatsu
Hideyuki
H
D019797:3-Iodobenzylguanidine; D001342:Autonomic Nervous System Diseases / Q000000981:diagnostic imaging / Q000401:mortality; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging* / Q000401:mortality*; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging* / Q000401:mortality*; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine