Francois Tournoux1, Renata Chequer2, Marjorie Sroussi3, Fabien Hyafil2,4, Vincent Algalarrondo5, Alain Cohen-Solal6, Paule Bodson-Clermont7, Dominique Le Guludec2,4, Francois Rouzet2,4. 1. Cardiologie, Centre Hospitalier de l'Université de Montréal, Montreal, Canada francois.tournoux@umontreal.ca. 2. AP-HP, Groupe Hospitalier Bichat-Claude Bernard, Service de Médecine Nucléaire, Paris, France. 3. Groupe Hospitalier Cochin-Saint Vincent de Paul, Université René Descartes-Paris 5, Paris, France. 4. Université Denis Diderot-Paris 7, U1148 Inserm, Paris, France. 5. Service de Cardiologie, CHU A. Béclère, APHP. U769, Labex Lermit, Clamart, France. 6. Service de Cardiologie, Hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, Paris 75010, France. 7. Centre de Recherche du CHUM (CRCHUM), Université de Montréal, Québec, Canada.
Abstract
AIMS: To assess the value of mechanical dyssynchrony measured by equilibrium radionuclide angiography (ERNA) in predicting long-term outcome in cardiac resynchronization therapy (CRT) patients. METHODS AND RESULTS: We reviewed 146 ERNA studies performed in heart failure patients between 2001 and 2011 at our institution. Long-term follow-up focused on death from any cause or heart transplantation. Phase images were computed using the first harmonic Fourier transform. Intra-ventricular dyssynchrony was calculated as the delay between the earliest and most delayed 20% of the left ventricular (LV) (IntraV-20/80) and inter-ventricular dyssynchrony as the difference between LV- and right ventricular (RV)-mode phase angles (InterV). Eighty-three patients (57%) were implanted with a CRT device after ERNA. Median follow-up was 35 [21-50] months. Twenty-four events were observed during the first 41 months. Median baseline ERNA dyssynchrony values were 28 [3 to 46] degrees for intraV-20/80 and 9 [-6 to 24] degrees for interV. Comparing survival between CRT and non-CRT patients according to dyssynchrony status, log-rank tests showed no difference in survival in patients with no ERNA dyssynchrony (P = 0.34) while a significant difference was observed in ERNA patients with high level of mechanical dyssynchrony (P = 0.004). CONCLUSION: ERNA mechanical dyssynchrony could be of value in CRT patient selection. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: To assess the value of mechanical dyssynchrony measured by equilibrium radionuclide angiography (ERNA) in predicting long-term outcome in cardiac resynchronization therapy (CRT) patients. METHODS AND RESULTS: We reviewed 146 ERNA studies performed in heart failurepatients between 2001 and 2011 at our institution. Long-term follow-up focused on death from any cause or heart transplantation. Phase images were computed using the first harmonic Fourier transform. Intra-ventricular dyssynchrony was calculated as the delay between the earliest and most delayed 20% of the left ventricular (LV) (IntraV-20/80) and inter-ventricular dyssynchrony as the difference between LV- and right ventricular (RV)-mode phase angles (InterV). Eighty-three patients (57%) were implanted with a CRT device after ERNA. Median follow-up was 35 [21-50] months. Twenty-four events were observed during the first 41 months. Median baseline ERNA dyssynchrony values were 28 [3 to 46] degrees for intraV-20/80 and 9 [-6 to 24] degrees for interV. Comparing survival between CRT and non-CRT patients according to dyssynchrony status, log-rank tests showed no difference in survival in patients with no ERNA dyssynchrony (P = 0.34) while a significant difference was observed in ERNA patients with high level of mechanical dyssynchrony (P = 0.004). CONCLUSION: ERNA mechanical dyssynchrony could be of value in CRT patient selection. Published on behalf of the European Society of Cardiology. All rights reserved.