Effect of Long-Term Beta-Blocker Therapy on Microvolt-Level T-Wave Alternans in Association With the Improvement of the Cardiac Sympathetic Nervous System and Systolic Function in Patients With Non-Ischemic Heart Disease

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The purpose of this study was to test a hypothesis that T-wave alternans (TWA) is improved in association with an improvement in cardiac sympathetic nervous system and systolic function by oral β-blocker therapy in patients with non-ischemic heart disease (NIHD). TWA testing, ^<123>I-metaiodobenzylguanidine (MIBG) imaging and echocardiography were performed at the baseline and 3 months after β-blocker therapy in 26 patients with NIHD and positive TWA. The alternans voltage (V_<alt>), the heart-to mediastinal-ratio on the early (e-H/M) and delayed (d-H/M) images, the washout rate (WR), the left ventricular ejection fraction (LVEF), and the calculated rate of change by β-blocker therapy in each parameter (ie, ΔV_<alt>, Δe-H/M, Δd-H/M, ΔWR and ΔLVEF) were measured. After therapy, TWA turned negative in 8 patients (group A) and remained positive in 18 (group B) ; V_<alt> was significantly decreased in group B (p<0.001). In group A, e-H/M, d-H/M and LVEF were significantly increased (e-H/M : p<0.05, d-H/M and LVEF : p<0.01), as were e-H/M and LVEF in group B (p<0.05). There were significant correlations between ΔV_<alt> and Δe-H/M (r=-0.61, p<0.01), Δd-H/M (r=-0.82, p<0.0001), ΔWR (r=0.60, p<0.01) and ΔLVEF (r=-0.70, p<0.01). In patients with NIHD, the TWA is improved in association with the improvement in cardiac sympathetic nervous system abnormalities and left veantricular systolic dysfunction by β-blocker therapy.
社団法人日本循環器学会の論文
2003-09-20

Effect of Long-Term Beta-Blocker Therapy on Microvolt-Level T-Wave Alternans in Association With the Improvement of the Cardiac Sympathetic Nervous System and Systolic Function in Patients With Non-Ischemic Heart Disease

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