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Clinical and gated SPECT MPI parameters associated with super-response to cardiac resynchronization therapy

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Journal of Nuclear Cardiology Aims and scope

Abstract

Purpose

We sought to evaluate the behavior of cardiac mechanical synchrony as measured by phase SD (PSD) derived from gated MPI SPECT (gSPECT) in patients with super-response after CRT and to evaluate the clinical and imaging characteristics associated with super-response.

Methods

158 subjects were evaluated with gSPECT before and 6 months after CRT. Patients with an improvement of LVEF > 15% and NYHA class I/II or reduction in LV end-systolic volume > 30% and NYHA class I/II were labeled as super-responders (SR).

Results

34 patients were classified as super-responders (22%) and had lower PSD (32° ± 17°) at 6 months after CRT compared to responders (45° ± 24°) and non-responders 46° ± 28° (P = .02 for both comparisons). Regression analysis identified predictors independently associated with super-response to CRT: absence of previous history of CAD (odds ratio 18.7; P = .002), absence of diabetes mellitus (odds ratio 13; P = .03), and history of hypertension (odds ratio .2; P = .01).

Conclusion

LV dyssynchrony after CRT implantation, but not at baseline, was significantly better among super-responders compared to non-super-responders. The absence of diabetes, absence of CAD, and history of hypertension were independently associated with super-response after CRT.

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Abbreviations

gSPECT:

gated MPI SPECT

PSD:

Phase standard deviation

CRT:

Cardiac resynchronization therapy

LBBB:

Left bundle branch block

LVEF:

Left ventricular ejection fraction

ESV:

End-systolic volume

IAEA:

International atomic energy agency

CAD:

Coronary artery disease

NYHA:

New York Heart Association

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Author information

Authors and Affiliations

  1. Hospital Universitario Antonio Pedro-Ebeserh UFF, Niteroi, 24033-900, Brazil

    Claudio T. Mesquita MD & Fernando de Amorim Fernandes

  2. Nuclear Medicine Department, Institute of Cardiology, La Habana, Cuba

    Amalia Peix

  3. Nuclear Medicine, Spedali Civili, Brescia, Italy

    Raffaele Giubbini

  4. All India Institute of Medical Sciences, New Delhi, India

    Ganesan Karthikeyan & Chetan Patel

  5. Hospital Clinico Universidad de Chile, Santiago, Chile

    Teresa Massardo

  6. Fundacion Valle del Lili, Cali, Colombia

    Luz M. Pabon

  7. Hospital Juan Ramon Jimenez, Huelva, Spain

    Amelia Jimenez-Heffernan

  8. Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, DF, Mexico

    Erick Alexanderson

  9. Oncology and Radiotherapy Institute (NORI), Islamabad, Pakistan

    Sadaf Butt

  10. Dr. B L Kapur Memorial Hospital, New Delhi, India

    Alka Kumar

  11. Fundacion Cardioinfantil, Bogota, Colombia

    Victor Marin

  12. Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency, Vienna, Austria

    Olga Morozova & Diana Paez

  13. Emory University, Atlanta, GA, USA

    Ernest V. Garcia

Authors
  1. Claudio T. Mesquita MD
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Correspondence to Claudio T. Mesquita MD.

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Mesquita, C.T., Peix, A., de Amorim Fernandes, F. et al. Clinical and gated SPECT MPI parameters associated with super-response to cardiac resynchronization therapy. J. Nucl. Cardiol. 29, 1166–1174 (2022). https://doi.org/10.1007/s12350-020-02414-8

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  • DOI: https://doi.org/10.1007/s12350-020-02414-8

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