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Journal of Nuclear Cardiology

, Volume 25, Issue 6, pp 2029–2038 | Cite as

Assessment of left ventricular contraction patterns using gated SPECT MPI to predict cardiac resynchronization therapy response

  • Ningchao Tao
  • Yuanhao Qiu
  • Haipeng Tang
  • Zhiyong Qian
  • Hongping Wu
  • Rui Zhu
  • Yao Wang
  • Xiaofeng Hou
  • Weihua Zhou
  • Jiangang Zou
Original Article

Abstract

Background

The U-shaped left ventricular (LV) contraction pattern, identified by MRI or echocardiography, is associated with improved CRT response. Gated SPECT MPI can measure both myocardial viability and mechanical dyssynchrony in a single scan. The aim of this study is to examine the relationship of the LV contraction pattern and the response of CRT in patients with left bundle branch block (LBBB).

Methods

Fifty-eight patients who met CRT guidelines and who had pre-CRT MPI were enrolled. Myocardial segments with tracer uptake < 50% of maximum were considered as scar. The LV contraction pattern was considered as U-shaped or non-U-shaped (U-shaped has a block line in the direction of contraction propagation). CRT response was defined as an increase in left ventricular ejection fraction ≥ 5% after 6-month follow-up.

Results

Twenty-eight patients (48%) had a U-shaped contraction pattern and thirty patients (52%) had a non-U-shaped contraction pattern. The U-shaped group showed a significantly higher response rate than the non-U-shaped group (90% vs. 57%; P = 0.005). By univariate and multivariate logistic regression analysis, the U-shaped pattern was an independent predictor of CRT response.

Conclusion

Non-invasive gated SPECT MPI can characterize LV mechanical contraction patterns. A U-shaped contraction pattern identified is associated with improved CRT response. This may prove useful for improved patient selection for CRT.

Keywords

SPECT MPI heart failure CRT contraction pattern left bundle branch block 

Abbreviations

SPECT

Single-photon emission computed tomography

MPI

Myocardial perfusion imaging/images

LV

Left ventricle/ventricular

CRT

Cardiac resynchronization therapy

LBBB

Left bundle branch block

LVMD

Left ventricular mechanical dyssynchrony

PSD

Phase standard deviation

PBW

Phase histogram bandwidth

Notes

Acknowledgements

This research was supported by a grant from Science and Technology Department of Jiangsu Province (Project Number: BE2016764, PI: Jiangang Zou) and a New Faculty startup grant from the University of Southern Mississippi (Project Number: DE01791, PI: Weihua Zhou).

Disclosure

The authors have declare that they have no conflict of interest.

Supplementary material

12350_2017_949_MOESM1_ESM.pptx (267 kb)
Supplementary material 1 (PPTX 266 kb)

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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Ningchao Tao
    • 1
  • Yuanhao Qiu
    • 1
  • Haipeng Tang
    • 2
  • Zhiyong Qian
    • 1
  • Hongping Wu
    • 1
  • Rui Zhu
    • 1
  • Yao Wang
    • 1
  • Xiaofeng Hou
    • 1
  • Weihua Zhou
    • 2
  • Jiangang Zou
    • 1
  1. 1.Department of CardiologyThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  2. 2.School of ComputingUniversity of Southern MississippiLong BeachUSA

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