Prognostic value of cardiac I-123 metaiodobenzylguanidine imaging in patients with non-insulin-dependent diabetes mellitus

J Nucl Cardiol. Jan-Feb 2006;13(1):34-42. doi: 10.1016/j.nuclcard.2005.11.009.

Abstract

Background: 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for diagnosing cardiac autonomic neuropathy (CAN) in non-insulin-dependent diabetes mellitus (NIDDM). However, the long-term prognostic value for cardiac events or mortality in NIDDM has not been clarified.

Methods and results: We investigated the long-term prognostic value of cardiac MIBG imaging for both cardiac event and mortality owing to a variety of causes of death in NIDDM. 144 NIDDM patients were analyzed retrospectively with the end-points of a cardiac event and various causes of mortality. The heart-to-mediastinum uptake ratio on the delayed image (H/M [d]) was obtained from anterior planar imaging. The mean follow-up period was 7.2+/-3.2 years. Seventeen patients had a cardiac event onset and 7 patients died during observation. During the same observation course, 16 patients died, including some who died of cardiac event. Both multivariate and univariate analyses revealed that decreased H/M (d) (<1.7) was the independent predictor of long-term mortality for a variety of causes of death. Although the value of H/M (d) was not a significant prognostic factor for predicting a cardiac event, CAN, diagnosed by a combination of H/M (d) and coefficient variance of RR interval, was an independent predictor for the cardiac event in NIDDM.

Conclusion: MIBG myocardial scintigraphy was useful for predicting cardiac events and long-term mortality in NIDDM.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • 3-Iodobenzylguanidine*
  • Autonomic Nervous System Diseases / diagnostic imaging
  • Autonomic Nervous System Diseases / mortality
  • Comorbidity
  • Diabetes Mellitus, Type 2 / diagnostic imaging*
  • Diabetes Mellitus, Type 2 / mortality*
  • Diabetic Neuropathies / diagnostic imaging*
  • Diabetic Neuropathies / mortality*
  • Female
  • Heart Diseases / diagnostic imaging*
  • Heart Diseases / mortality*
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Risk Assessment / methods
  • Risk Factors
  • Sensitivity and Specificity
  • Survival Analysis
  • Survival Rate

Substances

  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine