Perspective and future direction of intraventricular mechanical dyssynchrony assessment

Abstract

This editorial refers to the article published by Peix et al. 1 titled 'Value of intraventricular dyssynchrony assessment by gated-SPECT myocardial perfusion imaging in the management of heart failure patients undergoing cardiac resynchronization therapy (VISION-CRT)' on the Journal of Nuclear Cardiology. This study shows the importance of the current problem in cardiac resynchronization therapy (CRT). In this study, we observe multiple variables that can affect the CRT response in clinical practice 2 : patients with or without previous myocardial infarction, patients in ischemic cardiomyopathy phase, patients with or without myocardial ischemia, patients with or without coronary revascularization before gated SPECT study, patients with complete or incomplete revascularization, patients with or without myocardial viability criteria, patients with different large infarct size, patients with or without medical treatment optimizations during the follow-up, the cutoff value to define significant dyssynchrony, responder and non-responder patients, on-target group patients and off-target group patients, acquisition of images with different frames (8 or 16

Dyssynchrony as a marker of adverse prognosis among patients with coronary artery disease and heart failure

“…Some proponents of LVD have suggested that a normal MPI should be reported only when LVD is also normal in addition to perfusion, thickening, and function. 16 While this may be reasonable in a population without HF, as LVD may provide additive value, its application from a prognostic standpoint alone among those with CAD and HF needs careful consideration. In these patients is LVD a result of ischemia or stunning from CAD or driven by HF?…”