Dilated cardiomyopathy relieved as a result of β-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. β-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 β-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.
Key wordsMIBG BNP prognosis heart failure
- 10.Matsuo S, Nakamura Y, Kinoshita M, Hone M. Plasma B-type natriuretic peptide measurement in asymptomatic population.International Medical Journal 2003; 10 (2): 105–108.Google Scholar
- 12.Yamazaki J, Muto H, Kabano T, Yamashina S, Nanjo S, Inoue A. Evaluation of beta-blocker therapy in patients with dilated cardiomyopathy—Clinical meaning of iodine 123-metaiodobenzylguanidine myocardial single-photon emission computed tomography.Am Heart J 2001; 141 (4): 645–652.PubMedCrossRefGoogle Scholar
- 13.Nakata T, Wakabayashi T, Kyuma M, Takahashi T, Tsuchihashi K, Shimamoto K. Cardiac metaiodobenzylguanidine activity can predict the long-term efficacy of angiotensin-converting enzyme inhibitors and/or beta-adrenoceptor blockers in patients with heart failure.Eur J Nucl Med Mol Imaging 2005; 32 (2): 186–194.PubMedCrossRefGoogle Scholar
- 18.Imamura Y, Fukuyama T, Mochizuki T, Miyagawa M, Watanabe K; Ehime MIBG Heart Failure Study Investigators. Prognostic value of iodine-123-metaiodobenzyl-guanidine imaging and cardiac natriuretic peptide levels in patients with left ventricular dysfunction resulting from cardiomyopathy.Jpn Circ J 2001; 65 (3): 155–160.PubMedCrossRefGoogle Scholar