Are SPECT MPI measures of dyssynchrony dyssynchronous?

AbstractBackgroundAssessment of left ventricular mechanical dyssynchrony (LVMD) from gated SPECT myocardial perfusion imaging (MPI) aims to aid selection of patients for cardiac resynchronization therapy (CRT), using either the standard deviation of left ventricular phase (PSD) ≥ 43° or phase histogram bandwidth (HBW) of> 38 ° and> 30.6 ° in males and females, respectively. We observed dyssynchrony parameters might be affected by test type and alignment.MethodsWe reviewed 242 patients who underwent gated SPECT MPI with use of the Emory Cardiac Toolbox comparing PSD and HBW at rest and stress for Pearson correlation, and substitutability with Bland –Altman analysis.ResultsThere is statistically significant difference in the mean PSD and HBW during rest vs stress (33.4  ± 17.4° vs 20.7 ± 13.5° and 97.7 ± 59.6° vs 59.4 ± 45.4°, respectively,P 
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research

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Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
Abstract BACKGROUND: Super-responders (SRs) to cardiac resynchronization therapy (CRT) regain near-normal or normal cardiac function. The extent of cardiac synchrony of SRs and whether continuous biventricular (BIV) pacing is needed remain unknown. The aim of this study was to evaluate the cardiac electrical and mechanical synchrony of SRs. METHODS: We retrospectively analyzed CRT recipients between 2008 and 2016 in 2 centers to identify SRs, whose left ventricular (LV) ejection fraction was increased to ≥50% at follow-up. Cardiac synchrony was evaluated in intrinsic and BIV-paced rhythms. Electrical synch...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
ConclusionsThe fusion image technique using myocardial perfusion imaging and CT coronary venography is clinically feasible and promising for CRT optimization and enhancing the patient safety in patients with advanced HF.
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
AbstractBackgroundLeft ventricular diastolic dyssynchrony (LVDD) can be assessed by gated myocardial perfusion single-photon emission computed tomography (GMP-SPECT). LVDD is an area of interest in subjects who underwent cardiac resynchronization therapy (CRT). The aim of this post hoc analysis was to assess the role of LVDD in subjects with CRT who were followed up at 6-month period.Material&MethodsLeft ventricular diastolic dyssynchrony was assessed by GMP-SPECT at baseline and after CRT procedure in 160 subjects from 10 different cardiological centers. CRT procedure was performed as per current guidelines. Outcomes ...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
Abstract BACKGROUND: Cardiac resynchronization therapy (CRT) is an established heart failure (HF) treatment option, however its effect on ventricular arrhythmias (VAs) is controversial. Regional scar burden and high left ventricular (LV) pacing threshold (PT) are associated with poor outcome in CRT patients. The aim of our study was to analyze the impact of intraoperative LVPT on VA occurrence. METHODS: Eighty consecutive patients with advanced HF scheduled for a CRT defibrillator device [aged 63.3±10.9 years; New York Heart Association II-III 86.2%; 52 males (65%); 34 ischemic etiology (42.5%); 71 sin...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
ConclusionImprovement in septal thickening was associated with reverse remodeling, improvement in LVEF, and reduction of LVD.
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
ConclusionLV dyssynchrony improvement by gSPECT MPI, but not on-target lead placement, predicts clinical outcomes in patients undergoing CRT.
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
AbstractBackgroundPhase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy provides a measure of left ventricular dyssynchrony and may have applications for identifying patients suitable for cardiac resynchronisation therapy. Phase analysis is typically described in degrees of cardiac cycle, less intuitive to cardiologists familiar with ECGs. We assessed the relationship between time and degrees, to determine whether they are interchangeable.Methods and results399 patients underwent normal stress-only SPECT myocardial perfusion imaging using Technetium-99m-tetrofosmin. ...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
ConclusionAcute phase modifications after CRT activation may predict response to CRT immediately after implantation, but not at baseline, even when adjusted to perfusion data.
Source: Annals of Nuclear Medicine - Category: Nuclear Medicine Source Type: research
AbstractPurpose of ReviewAbout one-third patients selected for cardiac resynchronization therapy (CRT) based on conventional criteria do not show favourable response. Assessment of cardiac mechanical dyssynchrony by nuclear medicine techniques has generated considerable interest in recent years as an additional tool to improve the outcome of patients submitted to CRT.Recent FindingsSeveral studies in recent years have shown the utility of equilibrium radionuclide angiography (ERNA) and gated myocardial perfusion SPECT (GMPS) in predicting response to CRT. Both ERNA and GMPS can assess cardiac mechanical dyssynchrony quanti...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research
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