Chi-Yen Wang1,2, Guang-Uei Hung3, Hsu-Chung Lo1, Shih-Chuan Tsai4, Zhuo He5, Xinwei Zhang6, Kuo-Feng Chiang7, Jiangang Zou8, Weihua Zhou9,10, Jin-Long Huang11,12,13,14, Shih-Ann Chen1,15,16. 1. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan. 2. Institute of Medicine of Chung, Shan Medical University, Taichung, Taiwan. 3. Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan. 4. Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 5. College of Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA. 6. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. 7. Cardiology Division, Asian University Hospital, Taichung, Taiwan. 8. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. jgzou@njmu.edu.cn. 9. College of Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA. whzhou@mtu.edu. 10. Center of Biocomputing and Digital Health, Institute of Computing and Cybersystems, and Health Research Institute, Michigan Technological University, Houghton, USA. whzhou@mtu.edu. 11. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan. golden@vghtc.gov.tw. 12. Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan. golden@vghtc.gov.tw. 13. Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. golden@vghtc.gov.tw. 14. Department of Medical Education, Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. golden@vghtc.gov.tw. 15. Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. 16. Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: It had not been reported that myocardial scar shown on gated myocardial perfusion SPECT (GMPS) might reduce after cardiac resynchronization therapy (CRT). In this study, we aim to investigate the clinical impact and characteristic of scar reduction (SR) after CRT. METHODS AND RESULTS: Sixty-one heart failure patients following standard indication for CRT received twice GMPS as pre- and post-CRT evaluations. The patients with an absolute reduction of scar ≥ 10% after CRT were classified as the SR group while the rest were classified as the non-SR group. The SR group (N = 22, 36%) showed more improvement on LV function (∆LVEF: 18.1 ± 12.4 vs 9.4 ± 9.9 %, P = 0.007, ∆ESV: - 91.6 ± 52.6 vs - 38.1 ± 46.5 mL, P < 0.001) and dyssynchrony (ΔPSD: - 26.19 ± 18.42 vs - 5.8 ± 23.0°, P < 0.001, Δ BW: - 128.7 ± 82.8 vs - 25.2 ± 109.0°, P < 0.001) than non-SR group (N = 39, 64%). Multivariate logistic regression analysis showed baseline QRSd (95% CI 1.019-1.100, P = 0.006) and pre-CRT Reduced Wall Thickening (RWT) (95% CI 1.016-1.173, P = 0.028) were independent predictors for the development of SR. CONCLUSION: More than one third of patients showed SR after CRT who had more post-CRT improvement on LV function and dyssynchrony than those without SR. Wider QRSd and higher RWT before CRT were related to the development of SR after CRT.
BACKGROUND: It had not been reported that myocardial scar shown on gated myocardial perfusion SPECT (GMPS) might reduce after cardiac resynchronization therapy (CRT). In this study, we aim to investigate the clinical impact and characteristic of scar reduction (SR) after CRT. METHODS AND RESULTS: Sixty-one heart failure patients following standard indication for CRT received twice GMPS as pre- and post-CRT evaluations. The patients with an absolute reduction of scar ≥ 10% after CRT were classified as the SR group while the rest were classified as the non-SR group. The SR group (N = 22, 36%) showed more improvement on LV function (∆LVEF: 18.1 ± 12.4 vs 9.4 ± 9.9 %, P = 0.007, ∆ESV: - 91.6 ± 52.6 vs - 38.1 ± 46.5 mL, P < 0.001) and dyssynchrony (ΔPSD: - 26.19 ± 18.42 vs - 5.8 ± 23.0°, P < 0.001, Δ BW: - 128.7 ± 82.8 vs - 25.2 ± 109.0°, P < 0.001) than non-SR group (N = 39, 64%). Multivariate logistic regression analysis showed baseline QRSd (95% CI 1.019-1.100, P = 0.006) and pre-CRT Reduced Wall Thickening (RWT) (95% CI 1.016-1.173, P = 0.028) were independent predictors for the development of SR. CONCLUSION: More than one third of patients showed SR after CRT who had more post-CRT improvement on LV function and dyssynchrony than those without SR. Wider QRSd and higher RWT before CRT were related to the development of SR after CRT.
Authors: Samuel Fleischmann; Pascal Koepfli; Mehdi Namdar; Christophe A Wyss; Rolf Jenni; Philipp A Kaufmann Journal: J Nucl Med Date: 2004-05 Impact factor: 10.057