Effective prediction of response to cardiac resynchronization therapy using a novel program of gated myocardial perfusion single photon emission computed tomography

Nakamura, Kentaro; Takami, Mitsuru; Shimabukuro, Michio; Maesato, Akira; Chinen, Ichiro; Ishigaki, Shoichi; Higa, Satoshi; Keida, Takehiko; Masuzaki, Hiroaki

doi:10.1093/europace/eur143

Cited by 9 publications

(3 citation statements)

References 22 publications

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“…[37][38][39] CMR too had its own limitations, 38,40 particularly the availability and its application in patients with pacemakers. Finally SPECT with its recent software technology has attempted to predict potential responders, [41][42][43] but again it has similar limitations with availability, expertise, and the need for using radioactive isotopes.…”

Section: Three-dimensional Functionmentioning

confidence: 99%

The Clinical Dilemma of Quantifying Mechanical Left Ventricular Dyssynchrony for Cardiac Resynchronization Therapy: Segmental or Global?

Bajraktari

Henein

2014

Echocardiography

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Heart failure (HF) represents a serious clinical and public cause of mortality, morbidity, as well as healthcare expenditures. Guidelines for treatment of HF join in recommending multimedical regimen at targeted doses as the best medical strategy, despite that a significant percentage of patients remain symptomatic. Studies have shown that these patients might benefit from cardiac resynchronization therapy (CRT), particularly those presenting with broad QRS duration, >135 msec. Trials have already shown that CRT results in improved morbidity and survival of these patients particularly those in New York Heart Association class III-IV HF, but almost 30% do not show any symptomatic or survival benefit, hence are classified as nonresponders. Exhaustive efforts have been made in using noninvasive methods of assessing left ventricle (LV) dyssynchrony in predicting nonresponders to CRT, including Doppler echocardiography, magnetic resonance imaging, and even single photon emission computed tomography analysis, but only with modest success. In this report, we aimed to review the available evidence for assessing markers of mechanical LV dyssynchrony by various echocardiographic modalities and their respective strength in predicting favorable response to CRT treatment, comparing global with segmental ones. While the accuracy of segmental markers of dyssynchrony in predicting satisfactory response to CRT remains controversial because of various technical limitations, global markers seem easier to measure, reproducible, and potentially accurate in reflecting overall cavity response and its clinical implications. More studies are needed to qualify this proposal.

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Section: Three-dimensional Functionmentioning

confidence: 99%

The Clinical Dilemma of Quantifying Mechanical Left Ventricular Dyssynchrony for Cardiac Resynchronization Therapy: Segmental or Global?

Bajraktari

Henein

2014

Echocardiography

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“…Other SPECT studies have identified this disadvantage and have attempted different approaches to phase analysis for assessing dyssynchrony. [17][18][19] In this study, we propose adapting an existing technique, cluster analysis, to directly evaluate the TAC, thus, improving the assessment of quantification of mechanical dyssynchrony. Cluster analysis is a data analysis technique which classifies objects into groups, or clusters, based on the comparison criteria.…”

Section: Introductionmentioning

confidence: 99%

Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

et al. 2014

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“…[2][3][4][5][6][7][8] However, the QRS durations are usually different and diverse among the 12-lead electrocardiogram (ECG). 9) Additionally, in previous reports, the methods to define the QRS duration in predicting a CRT patient's outcome have discrepancies and lack standardization of QRS duration measurement.…”

mentioning

confidence: 99%

The Shortest QRS Duration of an Electrocardiogram Might Be an Optimal Electrocardiographic Predictor for Response to Cardiac Resynchronization Therapy

2017

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SummaryQRS duration has been associated with the response to cardiac resynchronization therapy (CRT). However, the methods for defining QRS duration to predict the outcome of CRT have discrepancies in previous reports. The aim of this study was to determine an optimal measurement of QRS duration to predict the response to CRT.Sixty-one patients who received CRT were analyzed. All patients had class III-IV heart failure, left ventricular ejection fraction not more than 35%, and complete left bundle branch block. The shortest, longest, and average QRS durations from the 12 leads of each electrocardiogram (ECG) were measured. The responses to CRT were determined using the changes in echocardiography after 6 months. Thirty-five (57.4%) patients were responders and 26 (42.6%) patients were non-responders. The pre-procedure shortest, average, and longest QRS durations and the QRS shortening (ΔQRS) of the shortest QRS duration were significantly associated with the response to CRT in a univariate logistic regression analysis (P = 0.002, P = 0.03, P = 0.04 and P = 0.04, respectively). Based on the measurement of the area under curve of the receiver operating characteristic curve, only the pre-procedure shortest QRS duration and the ΔQRS of the shortest QRS duration showed significant discrimination for the response to CRT (P = 0.002 and P = 0.038, respectively). Multivariable logistic regression showed the pre-procedure shortest QRS duration is an independent predictor for the response to CRT.The shortest QRS duration from the 12 leads of the electrocardiogram might be an optimal measurement to predict the response to CRT. (Int Heart J 2017; 58: 530-535) Key words: Heart failure C ardiac resynchronization therapy (CRT) is a wellknown procedure for improving left ventricular function via reverse remodeling in patients with heart failure.1) The QRS durations before implantation and at follow-up may predict the patient's response to CRT, especially in the presence of left bundle branch block (LBBB).2-8) However, the QRS durations are usually different and diverse among the 12-lead electrocardiogram (ECG). 9) Additionally, in previous reports, the methods to define the QRS duration in predicting a CRT patient's outcome have discrepancies and lack standardization of QRS duration measurement.10) Many different methods for QRS duration measurement have been used in previous studies, including the QRS duration of one selected lead, 11,12) the longest QRS duration, 13) the average QRS duration of 12 leads, 14) and undefined. 6,15,16) International guidelines for heart failure management also have not recommended a preferred standard measurement technique for QRS duration for CRT.2,10,17,18) Lack of standard measurement in the QRS duration might have a significant influence on the conclusions of different studies.10) Thus, this is the crucial reason why the recommended QRS duration for CRT implantation was different and variable in previous reports. However, the decision-making for suggesting that a patient receive a CRT implanta...

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Effective prediction of response to cardiac resynchronization therapy using a novel program of gated myocardial perfusion single photon emission computed tomography

Cited by 9 publications

References 22 publications

The Clinical Dilemma of Quantifying Mechanical Left Ventricular Dyssynchrony for Cardiac Resynchronization Therapy: Segmental or Global?

The Clinical Dilemma of Quantifying Mechanical Left Ventricular Dyssynchrony for Cardiac Resynchronization Therapy: Segmental or Global?

Development and optimization of SPECT gated blood pool cluster analysis for the prediction of CRT outcome

The Shortest QRS Duration of an Electrocardiogram Might Be an Optimal Electrocardiographic Predictor for Response to Cardiac Resynchronization Therapy

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