TY - JOUR
T1 - Ischemic patterns assessed by positron emission tomography predict adverse outcome in patients with idiopathic dilated cardiomyopathy
AU - de Jong, Richard M.
AU - Tio, Rene A.
AU - van der Harst, Pim
AU - Voors, Adriaan A.
AU - Koning, Paul M.
AU - Zeebregts, Clark J. A. M.
AU - van Veldhuisen, Dirk J.
AU - Dierckx, Rudi A. J. O.
AU - Slart, Riemer H. J. A.
PY - 2009/10
Y1 - 2009/10
N2 - 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.
AB - 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.
KW - Heart failure
KW - dilated cardiomyopathy
KW - positron emission tomography
KW - myocardial perfusion
KW - myocardial ischemia
KW - MYOCARDIAL BLOOD-FLOW
KW - CORONARY-ARTERY-DISEASE
KW - HEART-FAILURE
KW - CONGESTIVE CARDIOMYOPATHY
KW - VENTRICULAR DYSFUNCTION
KW - DOWN-REGULATION
KW - CARDIAC PET
KW - REVASCULARIZATION
KW - IMPROVEMENT
KW - VIABILITY
U2 - 10.1007/s12350-009-9130-9
DO - 10.1007/s12350-009-9130-9
M3 - Article
VL - 16
SP - 769
EP - 774
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
SN - 1071-3581
IS - 5
ER -