Quantitative assessment of dyssynchrony using ECG-gated SPECT myocardial perfusion imaging prior to and following cardiac resynchronization therapy

Circulation Journal : Official Journal of the Japanese Circulation Society
Takehiko KeidaMitsuaki Takami

Abstract

Cardiac resynchronization therapy (CRT) assists patients with advanced heart failure (HF) by improving left ventricular (LV) dyssynchrony, but there are significant numbers of non-responders, 1 reason being that the QRS duration is used as the only surrogate determinant of mechanical dyssynchrony, so an effective indicator of LV dyssynchrony is required. The present patient, who had HF, underwent CRT and showed clinical improvement with marked LV reverse remodeling. The regional contraction timing in the LV was assessed with software developed in an application on ECG-gated SPECT myocardial perfusion imaging that depicts the time-volume relationship of the segmented ventricular myocardium and the dispersion of time to end-systole as an expression of dyssynchrony. It was reduced in this patient following CRT. Discordance of systole in regional myocardial segments may present as mechanical dyssynchrony in the LV and could be used as an alternative to QRS duration. Quantitative assessment of dyssynchrony may be possible using this novel method, but further evaluation of the methodology is required.

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Citations

Mar 9, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshihiro SeoUNKNOWN J-CRT investigators
Nov 16, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Wataru KoguchiToshihiko Ishimitsu
Feb 11, 2016·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kenichi NakajimaErnest V Garcia
Aug 30, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Kentaro NakamuraHiroaki Masuzaki
Feb 18, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Angelo Auricchio, Frits W Prinzen
Dec 22, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Kenichi Nakajima
May 27, 2017·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kenichi NakajimaPiotr Slomka

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