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

作者：Tao, Ningchao; Qiu, Yuanhao; Tang, Haipeng; Qian, Zhiyong; Wu, Hongping; Zhu, Rui; Wang, Yao; Hou, Xiaofeng; Zhou, Weihua^*; Zou, Jiangang^*

来源：Journal of Nuclear Cardiology, 2018, 25(6): 2029-2038.

DOI：10.1007/s12350-017-0949-1

• SPECT MPI
• heart failure
• CRT
• contraction pattern
• left bundle branch block

BackgroundThe 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).MethodsFifty-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 fraction5% after 6-month follow-up.ResultsTwenty-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.ConclusionNon-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.

• 出版日期2018-12
• 单位南京医科大学