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Usefulness of scintigraphy to predict electrical storms in severe idiopathic dilated cardiomyopathy

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Abstract

Background

Although several predictors of an electrical storm (ES) are indicated in patients with idiopathic dilated cardiomyopathy (IDCM), whether the severity of the myocardial tissue damage (SMTD) evaluated by myocardial perfusion SPECT (MPS) has an association with an ES remains unclear. The purpose of this study was to elucidate the clinical significance of SMTD for the prediction of ES in IDCM patients with an ICD.

Methods

Thirty-seven (27 men, mean age 58 ± 15 years) IDCM patients receiving ICD implantations for secondary prevention with preoperative MPS were enrolled in this study. The medical history, physical and laboratory findings, electrocardiograms, echocardiograms and MPS findings were evaluated. The SMTD was assessed by the summed scores of 17 segments using a 4-point system (0, normal ~3, severe defect).

Results

During a mean follow-up of 43.9 ± 30.7 months, an ES developed in 12/37 (32.4 %) patients. The SMTD score predicted an ES with a 92 % sensitivity and 56 % specificity, at a cut-off score of 10. In addition, a multivariate analysis showed that the SMTD score remained an independent predictor of an ES (HR 1.09/score 1 increase, 95 % CI 1.01–1.19, p = 0.02). The SMTD score was significantly associated with three indices of late potentials on the signal-averaged electrocardiograms, and was significantly higher in patients with positive late potentials (p = 0.0006).

Conclusion

SMTD score assessed by MPS has a strong correlation to the late potentials and higher SMTD score may increase the risk of ES among patients with IDCM and an ICD.

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Authors and Affiliations

  1. Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan

    Masateru Takigawa, Takashi Noda, Takashi Kurita, Yuko Yamada, Hideo Okamura, Kazuhiro Satomi, Kazuhiro Suyama, Naohiko Aihara, Shiro Kamakura & Wataru Shimizu

  2. Division of Cardiology, Department of Medicine, Faculty of Medicine, Kiniki University, Sayama, Japan

    Takashi Kurita

  3. Cardiovascular Center, Japanese Red Cross Society Nagoya Daini Hospital, Nagoya, Japan

    Masateru Takigawa, Mamoru Nanasato & Haruo Hirayama

  4. Department of Radiology and Nuclear Medicine, National Cerebral and Cardiovascular Center, Suita, Japan

    Masateru Takigawa, Keisuke Kiso & Yoshio Ishida

  5. Department of Nuclear Medicine, Kansai Rosai Hospital, Amagasaki, Japan

    Yoshio Ishida

Authors
  1. Masateru Takigawa
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  2. Keisuke Kiso
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  3. Takashi Noda
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  4. Takashi Kurita
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  5. Yuko Yamada
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  6. Hideo Okamura
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  7. Kazuhiro Satomi
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  8. Kazuhiro Suyama
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  9. Naohiko Aihara
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  11. Haruo Hirayama
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  12. Shiro Kamakura
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  13. Wataru Shimizu
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  14. Yoshio Ishida
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Correspondence to Masateru Takigawa.

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Takigawa, M., Kiso, K., Noda, T. et al. Usefulness of scintigraphy to predict electrical storms in severe idiopathic dilated cardiomyopathy. Ann Nucl Med 27, 407–415 (2013). https://doi.org/10.1007/s12149-013-0699-3

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  • DOI: https://doi.org/10.1007/s12149-013-0699-3

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