C Patel1, M Kalaivani2, G Karthikeyan3, A Peix4, A Kumar5, T Massardo6, A Jiménez-Heffernan7, C T Mesquita8, M Pabon9, S Butt10, E Alexanderson11, V Marin12, O Morozova13, D Paez13, E V Garcia14. 1. All India Institute of Medical Sciences, New Delhi, India. cdpatel09@gmail.com. 2. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India. 3. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India. 4. Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba. 5. Dr. B L Kapur Memorial Hospital, New Delhi, India. 6. Hospital Clínico Universidad de Chile, Santiago, Chile. 7. Hospital Juan Ramón Jiménez, Huelva, Spain. 8. Hospital Universitario Antonio Pedro, Niteroi, Brazil. 9. Fundación Valle del Lili, Cali, Colombia. 10. Oncology and Radiotherapy Institute (NORI), Islamabad, Pakistan. 11. Instituto Nacional de Cardiología Ignacio Chávez, Mexico DF, Mexico. 12. Fundación Cardioinfantil, Bogotá, Colombia. 13. Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency, Vienna, Austria. 14. Emory University, Atlanta, United States of America.
Abstract
BACKGROUND: We evaluated the effect of cardiac resynchronization therapy (CRT) on septal perfusion and thickening at 6 months post implantation assessed on Tc99m-MIBI Gated myocardial perfusion SPECT (GMPS).We also studied the association of change in septal perfusion and thickening with primary outcome defined as at least one [improvement in ≥1NYHA class, left ventricular ejection fraction (LVEF) by ≥ 5%, reduction of end-systolic volume (ESV) by ≥ 15%, and improvement ≥ 5 points in Minnesota living with heart failure questionnaire (MLHFQ)]. METHOD: One hundred and five patients underwent clinical and GMPS evaluation before and at 6 months post CRT. RESULT: Post CRT there was significant improvement in mean normalized septal perfusion uptake and in septal thickening (P value = 0.001, both). There was no significant relation between improvement in septal perfusion and primary outcome. However, improvement in septal thickening was statistically significant with favorable primary outcome (P = 0.001).There was no significant correlation between improvement of septal perfusion and improvement in LVEF, reduction in End diastolic volume (EDV), ESV, and Left ventricular Dyssynchrony (LVD). But, there was significant correlation between improvement of septal thickening and these parameters. CONCLUSION: Improvement in septal thickening was associated with reverse remodeling, improvement in LVEF, and reduction of LVD.
BACKGROUND: We evaluated the effect of cardiac resynchronization therapy (CRT) on septal perfusion and thickening at 6 months post implantation assessed on Tc99m-MIBI Gated myocardial perfusion SPECT (GMPS).We also studied the association of change in septal perfusion and thickening with primary outcome defined as at least one [improvement in ≥1NYHA class, left ventricular ejection fraction (LVEF) by ≥ 5%, reduction of end-systolic volume (ESV) by ≥ 15%, and improvement ≥ 5 points in Minnesota living with heart failure questionnaire (MLHFQ)]. METHOD: One hundred and five patients underwent clinical and GMPS evaluation before and at 6 months post CRT. RESULT: Post CRT there was significant improvement in mean normalized septal perfusion uptake and in septal thickening (P value = 0.001, both). There was no significant relation between improvement in septal perfusion and primary outcome. However, improvement in septal thickening was statistically significant with favorable primary outcome (P = 0.001).There was no significant correlation between improvement of septal perfusion and improvement in LVEF, reduction in End diastolic volume (EDV), ESV, and Left ventricular Dyssynchrony (LVD). But, there was significant correlation between improvement of septal thickening and these parameters. CONCLUSION: Improvement in septal thickening was associated with reverse remodeling, improvement in LVEF, and reduction of LVD.