Long-term Effects of the Angiotensin-converting Enzyme Inhibitor Enalapril on Chronic Heart Failure : Examination by 123I-MIBG Imaging
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概要
- 論文の詳細を見る
To examine the long-term effects of the angiotensin-converting enzyme (ACE) inhibitor enalapril on chronic heart failure, 10 patients (7 men and 3 women, mean age: 62±11 years) with chronic stable heart failure, classified as New York Heart Association (NYHA) functional class 2-3 for more than 3 months, and a left ventricular ejection fraction less than 45% were treated with 2.5-5.0mg of enalapril once a day for 3-15 months (mean 7 months). The causes of heart failure were old myocardial infarction (n=7), hypertension (n=2), and atrial fibrillation (n=1). Radioiodinated metaiodobenzyl guanidine (123I-MIBG) imaging, radionuclide angiography, and treadmill exercise test were performed before and after the treatment. With enalapril treatment, (1) left ventricular ejection fraction (LVEF) increased significantly from 38.3±6.9% to 47.5±14.7%; (2) sub-maximal exercise time increased significantly from 205±112 to 272±120 seconds; (3) the heart to mediastinum (H/M) ratio of 123I-MIBG increased significantly (early image: 1.99±0.38 versus 2.20±0.50; delayed image: 1.86±0.44 versus 2.09±0.51); and (4) the washout rate of 123I-MIBG decreased slightly from 29.1±9.1% to 25.4±7.0%. The improvement rate of LVEF was significantly correlated with the improvement rates of the H/M ratio and washout rate after treatment with enalapril. Thus, the long-term effects of enalapril can be observed in the cardiac sympathetic nervous system, and 123I-MIBG imaging appears to be useful for evaluating the therapeutic effects of enalapril on the cardiac sympathetic nervous system in patients with chronic heart failure.
著者
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Yui Yasuko
Department Of Clinical Laboratory National Hospital Organization Zentsuji Hospital
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Tanaka Hideji
Department Of Cardiology Komatsushima Red Cross Hospital
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Soeki Takeshi
Department of Biochemistry, National Cardiovascular Center Research Institute
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Bandou Kanji
Department of Cardiology, Tokushima Red Cross Hospital
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Tamura Yoshiyuki
Department Of Cardiology And Clinical Research National Hospital Organization Zentsuji Hospital
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Shinohara Hisanori
Department Of Cardiology And Clinical Research
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TAMURA Yoshiyuki
Department of Cardiology, Zentsuji National Hospital
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TAKEICHI Naoki
Department of Cardiology, Zentsuji National Hospital
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FUKUDA Nobuo
Institute for Clinical Research, Zentsuji National Hospital
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SUI Osamu
Department of Radiology, Zentsuji National Hospital
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YUI Yasuko
Department of Cardiology, Zentsuji National Hospital
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SOEKI Takeshi
Department of Cardiology, Zentsuji National Hospital
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TANAKA Hideji
Department of Cardiology, Zentsuji National Hospital
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BANDOU Kanji
Department of Cardiology, Zentsuji National Hospital
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SHINOHARA Hisanori
Department of Cardiology, Zentsuji National Hospital
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