ナガオ　ミチノブ   長尾　充展    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Prediction of adverse cardiac events in dilated cardiomyopathy using cardiac T2* MRI and MIBG scintigraphy.
掲載誌名	正式名：The international journal of cardiovascular imaging 略　 称：Int J Cardiovasc Imaging ISSNコード：(1875-8312)1569-5794(Linking)
掲載区分	国外
巻・号・頁	31(2),pp.399-407
著者・共著者	Nagao Michinobu, Baba Shingo, Yonezawa Masato, Yamasaki Yuzo, Kamitani Takeshi, Isoda Takuro, Kawanami Satoshi, Maruoka Yasuhiro, Kitamura Yoshiyuki, Abe Kohtaro, Higo Taiki, Sunagawa Kenji, Honda Hiroshi
担当区分	筆頭著者,責任著者
発行年月	2015/02
概要	Iron deficiency and cardiac sympathetic impairment play a role in the worsening of heart failure, and these two conditions may be linked. The present study aimed to clarify the relationship between myocardial iron deficiency, cardiac sympathetic activity, and major adverse cardiac events (MACE) in patients with dilated cardiomyopathy (DCM). Cardiac T2* MRI for iron deficiency and (123)I-Metaiodobenzylguanidine (MIBG) imaging for cardiac sympathetic activity were performed in 46 patients with DCM. Myocardial T2* value (M-T2*) was calculated by fitting signal intensity data for mid-left ventricular septum to a decay curve using 3-Tesla scanner. (123)I-MIBG washout rate (MIBG-WR) was calculated using a polar-map technique with tomographic data. We analyze the ability of M-T2* and MIBG-WR to predict MACE. MIBG-WR and M-T2* were significantly greater in DCM patients with MACE than in patients without MACE. Receiver-operating-characteristics curve analysis showed that the optimal MIBG-WR and M-T2* thresholds of 35 % and 28.1 ms, and the two combination predict MACE with C-statics of 0.69, 0.73, and 0.82, respectively. Patients with MIBG-WR <35 % and M-T2* <28.1 ms had significantly lower event-free rates than those with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (log-rank value = 4.35, p < 0.05). Cox hazard regression analysis showed that χ(2) and the hazard ratio were 3.99 and 2.15 for development of MACE in patients with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (p < 0.05). Iron deficiency, expressed by a high M-T2*, and MIBG-WR were both independent predictors of MACE in patients with DCM. The two combination was a more powerful predictor of MACE than either parameter alone.
DOI	10.1007/s10554-014-0562-1
PMID	25348658