Baseline myocardial perfusion predicts response to cardiac resynchronization therapy: a prospective observational study

Purpose We prospectively determined whether preimplant myocardial perfusion imaging (MPI) predicts outcome with biventricular pacing (BiVP). Methods Single-photon emission computed tomography (SPECT) MPI, left ventricular (LV) volumes, ejection fraction (EF), 6-min hall walk (6MW) were assessed at b...

Full description

Saved in:
Bibliographic Details
Published in:Journal of interventional cardiac electrophysiology 2008-11, Vol.23 (2), p.127-133
Main Authors: Orlov, Michael V., Maysky, Michael, Akrivakis, Spyridon T., Ujhelyi, Michael R., Hoffmeister, Peter, Shukla, Gunjan, Mcallister, Susan, Kotler, Gregory, Almasry, Ibrahim, Chaudhry, G. Muqtada, Haffajee, Charles I.
Format: Article
Language:English
Subjects:
Aged
Cardiac Pacing, Artificial
Cardiology
Exercise Test
Female
Humans
Male
Medicine
Medicine & Public Health
Myocardial Ischemia - diagnostic imaging
Myocardial Ischemia - physiopathology
Myocardial Ischemia - therapy
Prospective Studies
Quality of Life
Radiopharmaceuticals
Statistics, Nonparametric
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed, Single-Photon
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose We prospectively determined whether preimplant myocardial perfusion imaging (MPI) predicts outcome with biventricular pacing (BiVP). Methods Single-photon emission computed tomography (SPECT) MPI, left ventricular (LV) volumes, ejection fraction (EF), 6-min hall walk (6MW) were assessed at baseline and at 4 months in 19 patients with ischemic cardiomyopathy undergoing BiVP. Clinical and hemodynamic responses were correlated with MPI. Results Lower global myocardial scar burden predicted hemodynamic response to BiVP, while higher burden was associated with poor response. Clinical improvement with BiVP occurred in 12 (63%) of the patients. Clinical BiVP responders had lower rest/stress MPI score difference. There was a close negative correlation between MPI reversibility and increased 6MW distance. Conclusions Baseline MPI is associated with clinical and hemodynamic response to BiVP: greater myocardial scar burden is predictive of poor hemodynamic response, while higher ischemic burden is predictive of poor clinical response. There is a differential response to BiVP by clinical and hemodynamic criteria.
ISSN:1383-875X
1572-8595
DOI:10.1007/s10840-008-9285-3