Clinical impacts of scar reduction on gated myocardial perfusion SPECT after cardiac resynchronization therapy.

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.

• Authors: Chi-Yen Wang, Guang-Uei Hung, Hsu-Chung Lo, Shih-Chuan Tsai, Zhuo He, Xinwei Zhang, Kuo-Feng Chiang, Jiangang Zou, Weihua Zhou, Jin-Long Huang, Shih-Ann Chen
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 29 Issue 5 Pg. 2571-2579 (Oct 2022) ISSN: 1532-6551 [Electronic] United States
• PMID: 34414552 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021. American Society of Nuclear Cardiology.

Chemical References

• Thionucleotides
• guanosine 5'-monophosphorothioate
• Guanosine Monophosphate

Topics

• Cardiac Resynchronization Therapy (methods)
• Cicatrix (diagnostic imaging)
• Guanosine Monophosphate
• Heart Failure (diagnostic imaging, therapy)
• Humans
• Myocardial Perfusion Imaging (methods)
• Perfusion
• Thionucleotides
• Tomography, Emission-Computed, Single-Photon (methods)
• Treatment Outcome