PMID- 23903666
OWN - NLM
STAT- MEDLINE
DCOM- 20140610
LR  - 20211021
IS  - 1619-7089 (Electronic)
IS  - 1619-7070 (Linking)
VI  - 40
IP  - 12
DP  - 2013 Dec
TI  - The amount of viable and dyssynchronous myocardium is associated with response to 
      cardiac resynchronization therapy: initial clinical results using multiparametric 
      ECG-gated [18F]FDG PET.
PG  - 1876-83
LID - 10.1007/s00259-013-2516-6 [doi]
AB  - PURPOSE: There is still a significant amount of patients who do not sufficiently 
      respond to cardiac resynchronization therapy (CRT). Previous studies demonstrated 
      that the amount of dyssynchronous myocardium was predictive of response to CRT. 
      Otherwise, non-response is frequently associated with high amounts of scar 
      tissue. The combination of these parameters might yield a more accurate 
      prediction of response. We hypothesized that the probability of a CRT response 
      increases with the presence of high amounts of "viable and dyssynchronous" 
      myocardium. METHODS: A total of 19 patients (17 male, 61 +/- 10 years) underwent 
      ECG-gated [(18)F]fluorodeoxyglucose (FDG) myocardial positron emission tomography 
      (PET) before CRT device implantation and were followed for 6 months. Response to 
      CRT was defined as clinical improvement of at least one New York Heart 
      Association (NYHA) class in combination with left ventricular (LV) ejection 
      fraction (EF) improvement of >5%. Twelve responders (71%) and seven 
      non-responders (29%) were identified. For each patient bullseye maps of FDG 
      uptake and phase analysis were calculated (QPS/QGS 2012, Cedars-Sinai, Los 
      Angeles, CA, USA) and fused. Amounts of myocardium representing "viable and 
      synchronous", "scar and synchronous", viable and dyssynchronous or "scar and 
      dyssynchronous" myocardium were quantified by planimetric measurements of the 
      fused bullseye maps. RESULTS: Responders by definition showed significant 
      decrease in NYHA class and significant increase of LVEF. Furthermore, a 
      significantly higher amount of viable and dyssynchronous myocardium was found as 
      compared to non-responders (21 +/- 13% vs 6 +/- 5%; p < 0.05). CONCLUSION: Combined 
      assessment of myocardial viability and LV dyssynchrony is feasible using 
      multiparametric [(18)F]FDG PET and could improve conventional response prediction 
      criteria for CRT.
FAU - Lehner, Sebastian
AU  - Lehner S
AD  - Department of Nuclear Medicine, University of Munich, Marchioninistr. 15, 81377, 
      Munich, Germany.
FAU - Uebleis, Christopher
AU  - Uebleis C
FAU - Schussler, Franziska
AU  - Schussler F
FAU - Haug, Alexander
AU  - Haug A
FAU - Kaab, Stefan
AU  - Kaab S
FAU - Bartenstein, Peter
AU  - Bartenstein P
FAU - Van Kriekinge, Serge D
AU  - Van Kriekinge SD
FAU - Germano, Guido
AU  - Germano G
FAU - Estner, Heidi
AU  - Estner H
FAU - Hacker, Marcus
AU  - Hacker M
LA  - eng
PT  - Journal Article
DEP - 20130801
PL  - Germany
TA  - Eur J Nucl Med Mol Imaging
JT  - European journal of nuclear medicine and molecular imaging
JID - 101140988
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - IM
MH  - *Cardiac Resynchronization Therapy
MH  - *Cardiac-Gated Imaging Techniques
MH  - Electrocardiography
MH  - Female
MH  - *Fluorodeoxyglucose F18
MH  - Heart/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - *Positron-Emission Tomography
MH  - *Tissue Survival
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/diagnostic imaging/physiopathology/therapy
EDAT- 2013/08/02 06:00
MHDA- 2014/06/11 06:00
CRDT- 2013/08/02 06:00
PHST- 2013/04/08 00:00 [received]
PHST- 2013/07/07 00:00 [accepted]
PHST- 2013/08/02 06:00 [entrez]
PHST- 2013/08/02 06:00 [pubmed]
PHST- 2014/06/11 06:00 [medline]
AID - 10.1007/s00259-013-2516-6 [doi]
PST - ppublish
SO  - Eur J Nucl Med Mol Imaging. 2013 Dec;40(12):1876-83. doi: 
      10.1007/s00259-013-2516-6. Epub 2013 Aug 1.