scholarly journals Three-dimensional left ventricular mechanical dyssynchrony assessed by myocardial perfusion gated-SPECT: Is there a role in cardiac resynchronization therapy?

2021 ◽  
Author(s):  
Cinzia Valzania ◽  
Riccardo Mei ◽  
Mauro Biffi
Keyword(s):  
Myocardial Perfusion ◽  
Cardiac Resynchronization Therapy ◽  
Gated Spect ◽  
Three Dimensional ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Left Ventricular Mechanical Dyssynchrony

scholarly journals The use of mechanical dyssynchrony for predicting response to cardiac resynchronization therapy in patients with non-ischemic cardiomyopathy

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
V Saushkin ◽  
YV Varlamova ◽  
AI Mishkina ◽  
DI Lebedev ◽  
SV Popov ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Myocardial Perfusion ◽  
Cardiac Resynchronization Therapy ◽  
Ischemic Cardiomyopathy ◽  
Gated Spect ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Crt Response

Abstract Funding Acknowledgements Type of funding sources: None. Aim/Introduction: Assessment of mechanical dyssynchrony by myocardial perfusion gated-SPECT in patients with non-ischemic cardiomyopathy for predict response to cardiac resynchronization therapy (CRT). Materials and Methods  We examined 32 patients with non-ischemic cardiomyopathy before and six months after CRT.  Left ventricular mechanical dyssynchrony and contractility were assessed for all patients by myocardial perfusion gated-SPECT. The phase standard deviation (PSD), histogram bandwidth (HBW), phase histogram skewness (S) and phase histogram kurtosis (K) were used as an indicator of mechanical dyssynchrony for the both ventricles.  Results  Mechanical dyssynchrony of both ventricles before CRT was increased in all patients. Median value PSD 53°(41-61°), HBW 176°(136-202°), S 1,62(1,21-1,89), K 2,81(1,21-3,49). Six months after CRT 22(68%) respondents were identified. We divided the patients into two groups (responders and non-responders) and compared phase parameters. It was found that the PSD (44°(35-54°)) and HBW (158°(118-179°) in the responders were significantly lower than in the non-responders (PSD (68°(58-72°); HBW (205°(199-249°)). The value of phase histogram skewness and kurtosis in responders were significantly higher (Responders: S 1,77(1,62-2,02); K 3,03(2,60-3,58). Non-responders: S 1,21(0,93-1,31); K 1,21(0,19-1,46)).  We found that all four indicators of mechanical dyssynchrony can predict CRT response according to the results of univariate logistic regression analysis. Moreover, It was found that only phase histogram kurtosis (OR = 1.196, 95% CI 1.04-1.37) is an independent predictor of CRT response according to multivariate logistic regression. Conclusion  Radionuclide assessment of mechanical dyssynchrony may be the optimal diagnostic method for selecting patients with non-ischemic cardiomyopathy on CRT.

scholarly journals The comparison of left ventricular mechanical dyssynchrony obtained by myocardial perfusion scintigraphy and gated blood pool SPECT to predict the result of the cardiac resynchronization therapy

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
A Mishkina ◽  
K Zavadovsky ◽  
V Shipulin ◽  
V Saushkin ◽  
YU Lishmanov
Keyword(s):  
Myocardial Perfusion ◽  
Myocardial Perfusion Scintigraphy ◽  
Blood Pool ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Perfusion Scintigraphy ◽  
Left Ventricular Mechanical Dyssynchrony ◽  
Crt Response

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction The assessment of left ventricular mechanical dyssynchrony (LV MD) is essential in identifying patients who may benefit from cardiac resynchronization therapy (CRT). Both gated myocardial perfusion scintigraphy (MPS) and gated blood pool SPECT (GBPS) are widely used to LV MD assessment [1,2]. Lack of data is available regarding the comparison of left ventricular MD parameters obtained by MPS and GBPS on cadmium-zinc-telluride (CZT) gamma-cameras and their prognostic value. Purpose to compare two scintigraphic methods – MPS and GBPS in LV MD assessment and to assess the capability of these methods to predict CRT response. Methods This study included 30 heart failure patients referred for CRT. Before CRT all patients underwent rest gated MPS and GBPS with LV MD evaluation on CZT cardiac gamma. Based on the phase analysis, the following indexes were estimated: phase standard deviation (SD) and phase histogram bandwidth (HBW). One year after CRT patients were divided to responders and non-responders. The response criteria were defined as LV end systolic volume decreased by ≥ 15% or LV ejection fraction increase by ≥ 5%, based on echocardiography. Results The correlation between gated MPI indexes and GBPS indexes was suboptimal: SD r = 0.39, p < 0.05; HBW r = 0.48, p < 0.05. Based on Mann-Whitney statistics significant differences between LV MD indexes, assessed by both MPS and GBPS were found: SD LV 56.1 (IQR 50.6 – 64) deg. vs 50.6 (37 - 61) deg., p < 0.05 and HBW LV 188.64 (176 - 213) deg. vs 201.68 (180 - 240) deg., p = 0.03, respectively. The Bland-Altman analysis showed poor agreement between gated MPS and GBPS for SD assessment (p = 0.02) with mean difference value 7.02 (96% CI 1.11 to 12.9). However both MPS and GBPS were comparable in terms of HBW estimation (p = 0.18), with mean difference value of -12.5 (96% CI -31.5 to 6.3).MD indexes derived by MPS differed significantly between CRT responders and non-responders: SD 53.56 (47 – 63.4) deg. vs 62.4 (56-71) deg., p < 0.05; HBW 182.1 (166 - 211) deg. vs 204.3 (179 - 225) deg., p < 0.05. MD indexes obtained by GBPS did not show significant difference in CRT responders and non-responders: SD 51.2 (37 – 62) deg. vs 49.4 (40 – 58) deg., p = 0.92 and HBW 203.4 (186 - 237) deg. vs 198.5 (174 - 240) deg., p = 073. Univariate logistic regression analysis showed that SD and HBW assessed by gated MPS were independent predictors of CRT response: SD (OR = 0.91; 95% CI 0.85-0.97; p < 0.05) and HBW (OR = 0.98; 95% CI 0.96-0.99; p =0.03). However MD indexes obtained by GBPS, did not show statistically significance in prediction of CRT response. Conclusion Gated MPS and GBPS are not interchangeable in terms of left ventricular MD assessment. Left ventricular SD and HBW obtained by gated MPI on CZT gamma-camera showed prognostic significance to predict CRT response.

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