Ischemic patterns assessed by positron emission tomography predict adverse outcome in patients with idiopathic dilated cardiomyopathy

Richard M. de Jong*, Rene A. Tio, Pim van der Harst, Adriaan A. Voors, Paul M. Koning, Clark J. A. M. Zeebregts, Dirk J. van Veldhuisen, Rudi A. J. O. Dierckx, Riemer H. J. A. Slart

*Corresponding author for this work

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Abstract

Although patients with idiopathic dilated cardiomyopathy (DCM) have no coronary artery disease, regional impairment of myocardial perfusion combined with preserved metabolism has been found using positron emission tomography (PET). Our aim was to assess the prognostic relevance of PET-mismatch between stress myocardial perfusion and glucose uptake on clinical outcome in DCM.

In 24 patients with DCM who underwent both myocardial perfusion and metabolism PET scanning, "mismatch" was assessed and the association with clinical outcome (hospitalization, mortality, and heart transplantation) was investigated.

Mismatch was found in 16 patients (66.7%). Univariate analysis showed that the presence of mismatch was associated with adverse outcome (P = 0.03). After adjustment for sex and age, the association remained significant with an adjusted relative risk of 10.4 (95% CI 1.1-103; P = 0.04) for death, heart transplant, or hospitalization. Univariate analysis also showed that a higher extent of mismatch was significantly associated with adverse outcome (P = 0.02). After adjusting for sex and age, the association remained significant with an adjusted relative risk of 6.5 [95% CI 1.2-36; P = 0.03] for death, heart transplantation, or hospitalization.

PET stress perfusion-metabolism mismatch, indicative for ischemia, is frequently found in DCM patients and related to a poorer outcome.

Original languageEnglish
Pages (from-to)769-774
Number of pages6
JournalJournal of Nuclear Cardiology
Volume16
Issue number5
DOIs
Publication statusPublished - Oct-2009

Keywords

  • Heart failure
  • dilated cardiomyopathy
  • positron emission tomography
  • myocardial perfusion
  • myocardial ischemia
  • MYOCARDIAL BLOOD-FLOW
  • CORONARY-ARTERY-DISEASE
  • HEART-FAILURE
  • CONGESTIVE CARDIOMYOPATHY
  • VENTRICULAR DYSFUNCTION
  • DOWN-REGULATION
  • CARDIAC PET
  • REVASCULARIZATION
  • IMPROVEMENT
  • VIABILITY

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