Dilated cardiomyopathy relieved as a result of beta-blocker therapy: a case report--key points in assessment of prognosis based on MIBG myocardial scintigraphy and BNP levels.

Abstract

A 48-year-old male patient was admitted to our hospital with dyspnea accompanied by orthopnea. Chest x-rays showed a cardiothoracic ratio of 68% and pulmonary congestion. He was diagnosed with dilated cardiomyopathy. Beta-Blocker (carvedilol) therapy was initiated on Day 22 of the disease using a small initial dose. He was followed up based on BNP levels and MIBG scintigraphy. The H/M ratio and MIBG washout rate were 1.98 and 33.4%, respectively, on Day 20 and 2.15 and 28.1%, respectively, on Day 72. The patient was discharged on Day 72 when congestive heart failure improved. Relatively high BNP levels were observed for 1 month after starting treatment with a beta-blocker. Plasma BNP levels were still as high when his heart failure was improved. BNP is useful as a convenient indicator for the severity of cardiac diseases. MIBG scintigraphy may be used thereafter to evaluate the severity in greater detail and more precisely determine the prognosis.

• Authors: Shinro Matsuo, Ichiro Nakae, Daisuke Masuda, Tetsuya Matsumoto, Minoru Horie
• Journal: Annals of nuclear medicine (Ann Nucl Med) Vol. 19 Issue 3 Pg. 243-6 (May 2005) ISSN: 0914-7187 [Print] Japan
• PMID: 15981680 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenergic beta-Antagonists
• Carbazoles
• Propanolamines
• Radiopharmaceuticals
• Carvedilol
• Natriuretic Peptide, Brain
• 3-Iodobenzylguanidine

Topics

• 3-Iodobenzylguanidine
• Adrenergic beta-Antagonists (therapeutic use)
• Carbazoles (therapeutic use)
• Cardiomyopathy, Dilated (blood, diagnosis, drug therapy)
• Carvedilol
• Follow-Up Studies
• Humans
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Prognosis
• Propanolamines (therapeutic use)
• Radiopharmaceuticals
• Severity of Illness Index
• Tomography, Emission-Computed, Single-Photon (methods)
• Treatment Outcome