Zhuo He1, Fernando de Amorim Fernandes2, Erivelton Alessandro do Nascimento3, Ernest V Garcia4, Claudio T Mesquita5,6, Weihua Zhou7. 1. Department of Applied Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA. 2. Nuclear Medicine Department, Hospital Universitario Antonio Pedro-EBSERH-UFF, Niteroi, Brazil. 3. Department of Cardiology, Hospital Universitario Antonio Pedro-EBSERH-UFF, Niteroi, Brazil. 4. Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA. 5. Nuclear Medicine Department, Hospital Universitario Antonio Pedro-EBSERH-UFF, Niteroi, Brazil. claudiotinocomesquita@gmail.com. 6. Nuclear Medicine Department, Hospital Pró-Cardíaco, Rio de Janeiro, Brazil. claudiotinocomesquita@gmail.com. 7. Department of Applied Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA. whzhou@mtu.edu.
Abstract
BACKGROUND: The purpose of this study was to evaluate the predictive value of left ventricular (LV) shape parameters measured by gated SPECT myocardial perfusion imaging (MPI) in super-responders enrolled in the VISION-CRT trial. METHODS: One hundred and ninety-nine patients who met standard criteria for CRT from multiple centers were enrolled in this study. End-systolic eccentricity (ESE) and end-diastolic eccentricity (EDE) were measures of LV shape. Super-responders were the patients who had a relative increase in left ventricular ejection fraction (LVEF) ≥ 15%. RESULTS: Complete data were obtained in 165 patients, and 43.6% of them were classified as super-responders. ESE was an independent predictor of CRT super-responders in univariate (OR 12.59, 95% CI 1.56-101.35, P = .017) and multivariate analysis (OR 35.71, 95% CI 1.66-766.03, P = .006). ESE had an incremental value over significant clinical and SPECT imaging variables, including angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker, coronary artery disease, myocardial infarction, LVEF, end-diastolic volume index, and scar burden (AUC 0.82 vs. 0.80, sensitivity 0.68 vs. 0.65, specificity 0.82 vs. 0.78). CONCLUSIONS: LV shape parameters derived from gated SPECT MPI have the promise to improve the prediction of the super-response to CRT. Moreover, ESE provides incremental value over existing clinical and nuclear imaging variables.
BACKGROUND: The purpose of this study was to evaluate the predictive value of left ventricular (LV) shape parameters measured by gated SPECT myocardial perfusion imaging (MPI) in super-responders enrolled in the VISION-CRT trial. METHODS: One hundred and ninety-nine patients who met standard criteria for CRT from multiple centers were enrolled in this study. End-systolic eccentricity (ESE) and end-diastolic eccentricity (EDE) were measures of LV shape. Super-responders were the patients who had a relative increase in left ventricular ejection fraction (LVEF) ≥ 15%. RESULTS: Complete data were obtained in 165 patients, and 43.6% of them were classified as super-responders. ESE was an independent predictor of CRT super-responders in univariate (OR 12.59, 95% CI 1.56-101.35, P = .017) and multivariate analysis (OR 35.71, 95% CI 1.66-766.03, P = .006). ESE had an incremental value over significant clinical and SPECT imaging variables, including angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker, coronary artery disease, myocardial infarction, LVEF, end-diastolic volume index, and scar burden (AUC 0.82 vs. 0.80, sensitivity 0.68 vs. 0.65, specificity 0.82 vs. 0.78). CONCLUSIONS: LV shape parameters derived from gated SPECT MPI have the promise to improve the prediction of the super-response to CRT. Moreover, ESE provides incremental value over existing clinical and nuclear imaging variables.
Authors: Paula S Azevedo; Bertha F Polegato; Marcos F Minicucci; Sergio A R Paiva; Leonardo A M Zornoff Journal: Arq Bras Cardiol Date: 2015-12-08 Impact factor: 2.000