PMID- 17574987
OWN - NLM
STAT- MEDLINE
DCOM- 20070827
LR  - 20220331
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 48
IP  - 7
DP  - 2007 Jul
TI  - Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion 
      SPECT predict response to CRT?
PG  - 1104-11
AB  - Cardiac resynchronization therapy (CRT) is now a well-recognized therapeutic 
      option for patients with end-stage heart failure. However, not all patients 
      respond to CRT, and, therefore, preimplantation identification of responders is 
      desirable. The aim of the present study was to investigate whether the degree of 
      left ventricular (LV) dyssynchrony, as assessed with phase analysis from gated 
      myocardial perfusion SPECT (GMPS), can predict which patients will respond to 
      CRT. METHODS: Forty-two patients with severe heart failure, depressed LV ejection 
      fraction, and wide QRS complex were prospectively included for implantation of a 
      CRT device and underwent GMPS and 2-dimensional echocardiography as part of the 
      clinical protocol. Clinical status was evaluated using the New York Heart 
      Association (NYHA) classification, 6-min walk test, and quality-of-life score. 
      The histogram bandwidth and phase SD (parameters indicating LV dyssynchrony) were 
      assessed from GMPS, and the clinical status and echocardiographic variables were 
      reassessed at 6-mo follow-up. RESULTS: Responders (71%) and nonresponders (29%) 
      had comparable baseline characteristics, except for histogram bandwidth (175 
      degrees +/- 63 degrees vs. 117 degrees +/- 51 degrees [P < 0.01]) and phase SD 
      (56.3 degrees +/- 19.9 degrees vs. 37 degrees .1 +/- 14.4 degrees [P < 0.01]), 
      which were significantly larger in responders compared with nonresponders. 
      Moreover, receiver-operating-characteristic curve analysis demonstrated an 
      optimal cutoff value of 135 degrees for histogram bandwidth (sensitivity and 
      specificity of 70%) and of 43 degrees for phase SD (sensitivity and specificity 
      of 74%) for the prediction of response to CRT. CONCLUSION: Response to CRT is 
      related to the presence of LV dyssynchrony assessed by phase analysis with GMPS. 
      A cutoff value of 135 degrees for histogram bandwidth and of 43 degrees for phase 
      SD could be used to predict response to CRT. Larger prospective studies are 
      warranted to confirm the present findings.
FAU - Henneman, Maureen M
AU  - Henneman MM
AD  - Department of Cardiology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Chen, Ji
AU  - Chen J
FAU - Dibbets-Schneider, Petra
AU  - Dibbets-Schneider P
FAU - Stokkel, Marcel P
AU  - Stokkel MP
FAU - Bleeker, Gabe B
AU  - Bleeker GB
FAU - Ypenburg, Claudia
AU  - Ypenburg C
FAU - van der Wall, Ernst E
AU  - van der Wall EE
FAU - Schalij, Martin J
AU  - Schalij MJ
FAU - Garcia, Ernest V
AU  - Garcia EV
FAU - Bax, Jeroen J
AU  - Bax JJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070615
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
SB  - IM
CIN - J Nucl Med. 2008 Apr;49(4):686; author reply 686. PMID: 18375927
MH  - Aged
MH  - *Cardiac Pacing, Artificial
MH  - *Coronary Circulation
MH  - Echocardiography/methods
MH  - Female
MH  - Heart Failure/*diagnosis/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Tomography, Emission-Computed, Single-Photon/methods
MH  - Ventricular Dysfunction, Left/*diagnosis
EDAT- 2007/06/19 09:00
MHDA- 2007/08/28 09:00
CRDT- 2007/06/19 09:00
PHST- 2007/06/19 09:00 [pubmed]
PHST- 2007/08/28 09:00 [medline]
PHST- 2007/06/19 09:00 [entrez]
AID - jnumed.107.039925 [pii]
AID - 10.2967/jnumed.107.039925 [doi]
PST - ppublish
SO  - J Nucl Med. 2007 Jul;48(7):1104-11. doi: 10.2967/jnumed.107.039925. Epub 2007 Jun 
      15.