| 김동희, 신동구, 조인호¹ , 조현수, 강상욱, 김웅, 이상희, 홍그루, 박종선, 김영조, 심봉섭 |
Background and Objectives:Ventricular arrhythmia is an important cause of sudden death in hypertrophic cardiomyopathy(HCM).The object of this study is to evaluate relation between cardiac MIBG parameter and the occurrence of ventricular tachycardia(VT) in patients with HCM.Methods: Forty-three patients(23 men, mean age 58.9±13.1 years) including clinically and echocardiographically proven HCM were studied and divided into 3 groups;patients with clinically documented VT(group A;6 patients ),without VT(group B;9 patients) and control (group C;28 patient).123I-MIBG was evaluated by early(15min) and delayed(3hours) uptake,heart to mediastinum uptake(H/M) ratio,global washout ratio(WOR) defined as [early H-delayed H]/early HX100.Polar map of LV myocardium were divided into 5 segments (anterior, septum, lateral, inferior and apex) and calculated regional uptake,H/M ratio and WOR.The LVEF,LVESD,LVEDD,septal wall thickness and the presence of LV outflow tract obstruction were determined by echocardiography.The clinical variables, echocardiographic and 123I-MIBG derived parameters were compared between the 3 groups.Results:There were no significant difference in age,LVEF,LVESD and LVEDD between the 3 groups.The septal wall thickness was not different between group A and B HCM patients.In HCM patients, a significant positive correlation was present between early septal uptake and LVESD(r=0.724, ρ=0.002),delayed septal uptake and LVEDD(r=0.758,ρ=0.001).Early septal uptake and delay septal uptake also showed a significant negative correlation with EF (r=-0.665,ρ=0.007 and r=-0.602,ρ=0.018 respectively).The average WOR showed tendency to be higher in HCM patients than control (0.34±0.85 and 0.33±0.10 vs 0.27±0.11).Group A patients had a lower early septal H/M ratio than group B,which was statistically significant(2.42±0.40 vs 3.02±0.51, ρ=0.018). Only early septal H/M ratio was positively correlated with septal wall thickness (r= 0.526, ρ=0.044).Conclusion:The occurrence of ventricular arrhythmia in HCM may be influenced by degree of regional septal wall uptake than that of other region or global uptake.These results support the clinical usefulness of cardiac 123I-MIBG scan as a prognostic tool in HCM patients.
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