title: Impact of myocardial perfusion abnormality on prognosis in patients with non-ischemic dilated cardiomyopathy.
abstract: BACKGROUND
  Myocardial perfusion imaging shows various patterns in patients with non-ischemic dilated cardiomyopathy (DCM). However, influences of regional abnormalities of myocardial perfusion or ventricular wall motion on prognosis in DCM patients remains to be clarified. Accordingly, we investigated a relation between myocardial perfusion patterns and long-term prognosis in DCM patients.
  
  
  RESULTS
  Sixty-two patients were divided into 2 groups according to patterns of (99m)Tc-Tetrofosmin scintigraphy, i.e. large focal defects (focal) and minimally impaired perfusion or multiple small defects (non-focal). There were no differences between the 2 groups in left ventricular (LV) end-diastolic dimensions (63.4 ± 9.1 and 63.8.4 ± 7.5mm, respectively) and LV ejection fraction (30.3 ± 9.2 and 27.9 ± 7.8%, respectively), indicating LV systolic dysfunction was comparable between the groups. The focal group had a higher prevalence of brain natriuretic peptide ≧ 200 ng/dl and plasma norepinephrine ≧ 500 pg/ml than the non-focal group (p<0.05), and had longer QRS durations (p<0.05). The focal group had non-sustained ventricular tachycardia (VT) (p<0.05) on 24-h electrocardiogram recording and a history of VT/ventricular fibrillation more frequently (p<0.05), and had higher New York Heart Association functional class than the non-focal group (p<0.05). The mortality was significantly higher in the focal group (56.0%) than in the non-focal group (28.6%) and the survival curves revealed worse prognosis in the focal group during a follow-up period of 5.3 ± 2.8 years.
  
  
  CONCLUSIONS
  Non-ischemic DCM patients with focal defects are accompanied by more advanced heart failure and poor prognosis compared to those with minimally impaired perfusion or multiple small defects, despite comparable LV systolic dysfunction.
authors: The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
authors: Mitsuo
authors: M
authors: Sobajima
authors: Takashi
authors: T
authors: Nozawa
authors: Takayuki
authors: T
authors: Suzuki
authors: Takashi
authors: T
authors: Ohori
authors: Takuya
authors: T
authors: Shida
authors: Akira
authors: A
authors: Matsuki
authors: Hiroshi
authors: H
authors: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011379:Prognosis; D012189:Retrospective Studies