Mesquita CT, Peix A, de Amorim Fernandes F, Giubbini R, Karthikeyan G, Massardo T, Patel C, Pabon LM, Jimenez-Heffernan A, Alexanderson E, Butt S, Kumar A, Marin V, Morozova O, Paez D, Garcia EV. Clinical and gated SPECT MPI parameters associated with super-response to cardiac resynchronization therapy.
J Nucl Cardiol 2022;
29:1166-1174. [PMID:
33152098 DOI:
10.1007/s12350-020-02414-8]
[Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE
We sought to evaluate the behavior of cardiac mechanical synchrony as measured by phase SD (PSD) derived from gated MPI SPECT (gSPECT) in patients with super-response after CRT and to evaluate the clinical and imaging characteristics associated with super-response.
METHODS
158 subjects were evaluated with gSPECT before and 6 months after CRT. Patients with an improvement of LVEF > 15% and NYHA class I/II or reduction in LV end-systolic volume > 30% and NYHA class I/II were labeled as super-responders (SR).
RESULTS
34 patients were classified as super-responders (22%) and had lower PSD (32° ± 17°) at 6 months after CRT compared to responders (45° ± 24°) and non-responders 46° ± 28° (P = .02 for both comparisons). Regression analysis identified predictors independently associated with super-response to CRT: absence of previous history of CAD (odds ratio 18.7; P = .002), absence of diabetes mellitus (odds ratio 13; P = .03), and history of hypertension (odds ratio .2; P = .01).
CONCLUSION
LV dyssynchrony after CRT implantation, but not at baseline, was significantly better among super-responders compared to non-super-responders. The absence of diabetes, absence of CAD, and history of hypertension were independently associated with super-response after CRT.
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