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Myocardial perfusion reserve and contractile pattern after beta-blocker therapy in patients with idiopathic dilated

R H J A Slart1, R A Tio, P A van der Vleuten

  • 1Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30001, 9700 RB Groningen, The Netherlands. r.h.j.a.slart@nucl.umcg.nl

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|March 19, 2010
PubMed

Insights

Idiopathic Dilated Cardiomyopathy (IDC) patients responding to beta-blockers show improved myocardial perfusion reserve. Non-responders experience a decrease in perfusion reserve, correlating with worsening left ventricular function.

Area of Science:

  • Cardiology
  • Nuclear Cardiology
  • Cardiovascular Imaging

Background:

  • Idiopathic Dilated Cardiomyopathy (IDC) is linked to myocardial oxygen supply-demand imbalance.
  • Subclinical ischemia may worsen left ventricular (LV) function in IDC.
  • Beta-blockers are standard therapy, but patient response varies.

Purpose of the Study:

  • To identify differences in regional myocardial perfusion reserve (MPR) and contractile function between beta-blocker responders and non-responders in IDC.
  • To assess if MPR and LV function changes correlate with beta-blocker treatment outcomes.

Main Methods:

  • Patients with newly diagnosed IDC underwent baseline and stress Positron Emission Tomography (PET) for MPR and dobutamine stress Magnetic Resonance Imaging (MRI) for contractile function.
  • PET and MRI were repeated after 6 months of maximal beta-blocker therapy.
  • Myocardial perfusion reserve (MPR) and wall motion score (WMS) were evaluated using a 17-segment model.

Main Results:

  • Responders showed significant improvement in MPR (1.56 to 1.93) and wall motion scores.
  • Non-responders exhibited a non-significant decrease in MPR (1.98 to 1.61) and no change in wall motion.
  • A significant correlation was found between changes in MPR and LVEF; decreased MPR was associated with decreased LVEF.

Conclusions:

  • In IDC, improved LV function with beta-blockers correlates with enhanced regional perfusion.
  • Deterioration of LV function in IDC patients on beta-blockers is associated with reduced myocardial perfusion reserve.
  • MPR assessment may help differentiate treatment response in IDC.
Abstract

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