Guang-Uei Hung1, Jiangang Zou2, Zhuo He3, Xinwei Zhang2, Shih-Chuan Tsai4, Chi-Yen Wang5, Kuo-Feng Chiang6, Haipeng Tang7, Ernest V Garcia8, Weihua Zhou9, Jin-Long Huang10. 1. Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan. 2. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. 3. College of Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA. 4. Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 5. Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. 6. Division of Cardiology, Department of Medicine Sections, Asia University Hospital, Taichung, Taiwan. 7. School of Computing, University of Southern Mississippi, Hattiesburg, MS, USA. 8. Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA. 9. College of Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA. whzhou@mtu.edu. 10. Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. golden@vghtc.gov.tw.
Abstract
OBJECTIVES: Gated myocardial perfusion SPECT (GMPS) provides a one-stop-shop evaluation for cardiac resynchronization therapy (CRT). However, conflicting results have been observed regarding whether the baseline left-ventricular (LV) mechanical dyssynchrony as assessed by phase analysis on GMPS was predictive of therapeutic response to CRT. Since dyssynchrony parameters by phase analysis spuriously increased by scarred myocardium, the purpose of this study was to explore the value of dyssynchrony after stripping off the scar region in correlation to mechanical response to CRT. METHODS: Forty-seven patients following standard indications for CRT received GMPS with phase analysis as pre-CRT evaluation. A decrease of end-systolic volume (ESV) > 15% on follow-up echocardiography after CRT was considered as a mechanical response to CRT. Myocardial regions with less than 50% of maximal activity on GMPS were considered as a scar. The phase standard deviation (PSD) and histogram bandwidth (BW) without or with stripping off scar were assessed by phase analysis of GMPS and were used for evaluation of LV dyssynchrony of all myocardium or only the viable myocardium, respectively. RESULTS: No significant difference was noted between mechanical responders (31 of 47 patients, 66%) and nonresponders ( 16 of 47 patients, 34%) for PSD (48.6° ± 19.4° vs 43.9° ± 20.7°, p = 0.46) and BW (225° ± 91.1° vs 163.5° ± 94.6°, p = 0.38) of the entire myocardium. However, responders had significantly larger PSD (40.5° ± 15.7° vs 30.5° ± 13.2°, p = 0.03) and borderlinely larger BW (215° ± 91.2° vs. 139.5° ± 78.2°, p = 0.05) than non-responders after stripping off scar. Logistic regression analysis showed that scar area and PSD after stripping off scar were independent predictors of mechanical response. CONCLUSIONS: Our result showed that LV dyssynchrony of the entire myocardium did not predict response to CRT. However, LV dyssynchrony only in the viable myocardium was a significant predictor of CRT mechanical response.
OBJECTIVES: Gated myocardial perfusion SPECT (GMPS) provides a one-stop-shop evaluation for cardiac resynchronization therapy (CRT). However, conflicting results have been observed regarding whether the baseline left-ventricular (LV) mechanical dyssynchrony as assessed by phase analysis on GMPS was predictive of therapeutic response to CRT. Since dyssynchrony parameters by phase analysis spuriously increased by scarred myocardium, the purpose of this study was to explore the value of dyssynchrony after stripping off the scar region in correlation to mechanical response to CRT. METHODS: Forty-seven patients following standard indications for CRT received GMPS with phase analysis as pre-CRT evaluation. A decrease of end-systolic volume (ESV) > 15% on follow-up echocardiography after CRT was considered as a mechanical response to CRT. Myocardial regions with less than 50% of maximal activity on GMPS were considered as a scar. The phase standard deviation (PSD) and histogram bandwidth (BW) without or with stripping off scar were assessed by phase analysis of GMPS and were used for evaluation of LV dyssynchrony of all myocardium or only the viable myocardium, respectively. RESULTS: No significant difference was noted between mechanical responders (31 of 47 patients, 66%) and nonresponders ( 16 of 47 patients, 34%) for PSD (48.6° ± 19.4° vs 43.9° ± 20.7°, p = 0.46) and BW (225° ± 91.1° vs 163.5° ± 94.6°, p = 0.38) of the entire myocardium. However, responders had significantly larger PSD (40.5° ± 15.7° vs 30.5° ± 13.2°, p = 0.03) and borderlinely larger BW (215° ± 91.2° vs. 139.5° ± 78.2°, p = 0.05) than non-responders after stripping off scar. Logistic regression analysis showed that scar area and PSD after stripping off scar were independent predictors of mechanical response. CONCLUSIONS: Our result showed that LV dyssynchrony of the entire myocardium did not predict response to CRT. However, LV dyssynchrony only in the viable myocardium was a significant predictor of CRT mechanical response.
Authors: Claudia Ypenburg; Martin J Schalij; Gabe B Bleeker; Paul Steendijk; Eric Boersma; Petra Dibbets-Schneider; Marcel P Stokkel; Ernst E van der Wall; Jeroen J Bax Journal: J Nucl Med Date: 2006-10 Impact factor: 10.057
Authors: Anna I Mishkina; Victor V Saushkin; Tariel A Atabekov; Svetlana I Sazonova; Vladimir V Shipulin; Samia Massalha; Roman E Batalov; Sergey V Popov; Konstantin V Zavadovsky Journal: J Nucl Cardiol Date: 2022-07-14 Impact factor: 3.872