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Effect of cardiac resynchronization therapy on septal perfusion and septal thickening: Association with left ventricular function, reverse remodelling and dyssynchrony

  • C. PatelEmail author
  • M. Kalaivani
  • G. Karthikeyan
  • A. Peix
  • A. Kumar
  • T. Massardo
  • A. Jiménez-Heffernan
  • C. T. Mesquita
  • M. Pabon
  • S. Butt
  • E. Alexanderson
  • V. Marin
  • O. Morozova
  • D. Paez
  • E. V. Garcia
Original Article
  • 25 Downloads

Abstract

Background

We evaluated the effect of cardiac resynchronization therapy (CRT) on septal perfusion and thickening at 6 months post implantation assessed on Tc99m-MIBI Gated myocardial perfusion SPECT (GMPS).We also studied the association of change in septal perfusion and thickening with primary outcome defined as at least one [improvement in ≥1NYHA class, left ventricular ejection fraction (LVEF) by ≥ 5%, reduction of end-systolic volume (ESV) by ≥ 15%, and improvement ≥ 5 points in Minnesota living with heart failure questionnaire (MLHFQ)].

Method

One hundred and five patients underwent clinical and GMPS evaluation before and at 6 months post CRT.

Result

Post CRT there was significant improvement in mean normalized septal perfusion uptake and in septal thickening (P value = 0.001, both). There was no significant relation between improvement in septal perfusion and primary outcome. However, improvement in septal thickening was statistically significant with favorable primary outcome (P = 0.001).There was no significant correlation between improvement of septal perfusion and improvement in LVEF, reduction in End diastolic volume (EDV), ESV, and Left ventricular Dyssynchrony (LVD). But, there was significant correlation between improvement of septal thickening and these parameters.

Conclusion

Improvement in septal thickening was associated with reverse remodeling, improvement in LVEF, and reduction of LVD.

Keywords

Heart failure SPECT dyssynchrony 

Abbreviations

CRT

Cardiac resynchronization therapy

HF

Heart failure

LBBB

Left bundle branch block

LVEF

Left ventricular ejection fraction

GMPS

Gated myocardial perfusion SPECT

LVD

Left ventricular dyssynchrony

MLHFQ

Minnesota living with heart failure questionnaire

PSD

Phase standard deviation

RBBB

Right bundle branch block

OSEM

Ordered subset expectation maximization

Notes

Disclosure

Dr Garcia receives royalties from the sale of the Emory Cardiac Toolbox used in this research. The terms of this arrangement have been reviewed and approved by Emory University in accordance with its COI practice. He is also a consultant for Syntermed Inc and GE Healthcare. There are no other relationships with industry.

Supplementary material

12350_2019_1704_MOESM1_ESM.pptx (319 kb)
Supplementary material 1 (PPTX 319 kb)

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Copyright information

© American Society of Nuclear Cardiology 2019

Authors and Affiliations

  • C. Patel
    • 1
    Email author
  • M. Kalaivani
    • 2
  • G. Karthikeyan
    • 3
  • A. Peix
    • 4
  • A. Kumar
    • 5
  • T. Massardo
    • 6
  • A. Jiménez-Heffernan
    • 7
  • C. T. Mesquita
    • 8
  • M. Pabon
    • 9
  • S. Butt
    • 10
  • E. Alexanderson
    • 11
  • V. Marin
    • 12
  • O. Morozova
    • 13
  • D. Paez
    • 13
  • E. V. Garcia
    • 14
  1. 1.All India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of BiostatisticsAll India Institute of Medical SciencesNew DelhiIndia
  3. 3.Department of CardiologyAll India Institute of Medical SciencesNew DelhiIndia
  4. 4.Instituto de Cardiología y Cirugía CardiovascularLa HabanaCuba
  5. 5.Dr. B L Kapur Memorial HospitalNew DelhiIndia
  6. 6.Hospital Clínico Universidad de ChileSantiagoChile
  7. 7.Hospital Juan Ramón JiménezHuelvaSpain
  8. 8.Hospital Universitario Antonio PedroNiteroiBrazil
  9. 9.Fundación Valle del LiliCaliColombia
  10. 10.Oncology and Radiotherapy Institute (NORI)IslamabadPakistan
  11. 11.Instituto Nacional de Cardiología Ignacio ChávezMexico DFMexico
  12. 12.Fundación CardioinfantilBogotáColombia
  13. 13.Nuclear Medicine and Diagnostic Imaging SectionInternational Atomic Energy AgencyViennaAustria
  14. 14.Emory UniversityAtlantaUnited States of America

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