1. Clinical impacts of scar reduction on gated myocardial perfusion SPECT after cardiac resynchronization therapy
- Author
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Chi Yen Wang, Shih Ann Chen, Shih-Chuan Tsai, Jin Long Huang, Hsu Chung Lo, Weihua Zhou, Zhuo He, Guang Uei Hung, Xinwei Zhang, Kuo Feng Chiang, and Jiangang Zou
- Subjects
Lv function ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Cardiac resynchronization therapy ,medicine.disease ,Internal medicine ,Heart failure ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Thickening ,Cardiology and Cardiovascular Medicine ,Phase analysis ,business ,Perfusion - Abstract
It had not been reported that myocardial scar shown on gated myocardial perfusion SPECT (GMPS) might reduce after cardiac resynchronization therapy (CRT). In this study, we aim to investigate the clinical impact and characteristic of scar reduction (SR) after CRT. Sixty-one heart failure patients following standard indication for CRT received twice GMPS as pre- and post-CRT evaluations. The patients with an absolute reduction of scar ≥ 10% after CRT were classified as the SR group while the rest were classified as the non-SR group. The SR group (N = 22, 36%) showed more improvement on LV function (∆LVEF: 18.1 ± 12.4 vs 9.4 ± 9.9 %, P = 0.007, ∆ESV: − 91.6 ± 52.6 vs − 38.1 ± 46.5 mL, P < 0.001) and dyssynchrony (ΔPSD: − 26.19 ± 18.42 vs − 5.8 ± 23.0°, P < 0.001, Δ BW: − 128.7 ± 82.8 vs − 25.2 ± 109.0°, P < 0.001) than non-SR group (N = 39, 64%). Multivariate logistic regression analysis showed baseline QRSd (95% CI 1.019-1.100, P = 0.006) and pre-CRT Reduced Wall Thickening (RWT) (95% CI 1.016-1.173, P = 0.028) were independent predictors for the development of SR. More than one third of patients showed SR after CRT who had more post-CRT improvement on LV function and dyssynchrony than those without SR. Wider QRSd and higher RWT before CRT were related to the development of SR after CRT.
- Published
- 2021