Current Cardiovascular Imaging Reports

, Volume 4, Issue 3, pp 199-206

First online:

SPECT and Cardiac Resynchronization Therapy

  • Ji ChenAffiliated withDepartment of Radiology, Emory University School of Medicine Email author 
  • , Mark J. BoogersAffiliated withDepartment of Cardiology, Leiden University Medical CenterThe Interuniversity Cardiology Institute of The Netherlands Email author 
  • , Prem SomanAffiliated withCardiovascular Institute, University of Pittsburgh Medical CenterDivision of Nuclear Cardiology, University of Pittsburgh Medical Center Email author 
  • , Ernest V. GarciaAffiliated withDepartment of Radiology, Emory University School of Medicine Email author 

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Cardiac resynchronization therapy (CRT) has proven benefits in patients with refractory heart failure including improved symptoms, exercise capacity, quality of life, and left ventricular (LV) function, and mortality benefits. At present, CRT is recommended in patients with severe refractory heart failure (New York Heart Association class III or IV), LV ejection fraction ≤ 35%, QRS duration ≥ 120 ms, and sinus rhythm. When selected based on these standard indications, 20% to 40% of patients fail to respond to CRT. Important parameters for predicting CRT response, such as LV mechanical dyssynchrony, myocardial scar, and LV pacing lead position, have been studied using phase analysis of gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). This review aims to describe the role of gated SPECT MPI for the comprehensive assessment of those parameters for selection of patients for CRT.


Cardiac resynchronization therapy Myocardial perfusion imaging SPECT Phase analysis