| Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT? | |
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MedLine Citation:
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PMID: 17574987 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiac resynchronization therapy (CRT) is now a well-recognized therapeutic option for patients with end-stage heart failure. However, not all patients respond to CRT, and, therefore, preimplantation identification of responders is desirable. The aim of the present study was to investigate whether the degree of left ventricular (LV) dyssynchrony, as assessed with phase analysis from gated myocardial perfusion SPECT (GMPS), can predict which patients will respond to CRT. METHODS: Forty-two patients with severe heart failure, depressed LV ejection fraction, and wide QRS complex were prospectively included for implantation of a CRT device and underwent GMPS and 2-dimensional echocardiography as part of the clinical protocol. Clinical status was evaluated using the New York Heart Association (NYHA) classification, 6-min walk test, and quality-of-life score. The histogram bandwidth and phase SD (parameters indicating LV dyssynchrony) were assessed from GMPS, and the clinical status and echocardiographic variables were reassessed at 6-mo follow-up. RESULTS: Responders (71%) and nonresponders (29%) had comparable baseline characteristics, except for histogram bandwidth (175 degrees +/- 63 degrees vs. 117 degrees +/- 51 degrees [P < 0.01]) and phase SD (56.3 degrees +/- 19.9 degrees vs. 37 degrees .1 +/- 14.4 degrees [P < 0.01]), which were significantly larger in responders compared with nonresponders. Moreover, receiver-operating-characteristic curve analysis demonstrated an optimal cutoff value of 135 degrees for histogram bandwidth (sensitivity and specificity of 70%) and of 43 degrees for phase SD (sensitivity and specificity of 74%) for the prediction of response to CRT. CONCLUSION: Response to CRT is related to the presence of LV dyssynchrony assessed by phase analysis with GMPS. A cutoff value of 135 degrees for histogram bandwidth and of 43 degrees for phase SD could be used to predict response to CRT. Larger prospective studies are warranted to confirm the present findings. |
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Authors:
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Maureen M Henneman; Ji Chen; Petra Dibbets-Schneider; Marcel P Stokkel; Gabe B Bleeker; Claudia Ypenburg; Ernst E van der Wall; Martin J Schalij; Ernest V Garcia; Jeroen J Bax |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-06-15 |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 48 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-07-03 Completed Date: 2007-08-27 Revised Date: 2008-05-30 |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 1104-11 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Pacing, Artificial* Coronary Circulation* Echocardiography / methods Female Heart Failure / diagnosis*, therapy Humans Male Middle Aged Predictive Value of Tests Tomography, Emission-Computed, Single-Photon / methods Ventricular Dysfunction, Left / diagnosis* |
| Comments/Corrections | |
Comment In:
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J Nucl Med. 2008 Apr;49(4):686; author reply 686
[PMID:
18375927
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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