A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization Therapy
BackgroundUsing single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) with phase analysis (PA), we aimed to identify the predictive value of a new contraction pattern in cardiac resynchronization therapy (CRT) response.MethodsLeft ventricular mechanical dyssynchrony (LV...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.906467/full |
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| author | Xiao Hu Xiao Hu Zhiyong Qian Fengwei Zou Siyuan Xue Xinwei Zhang Yao Wang Xiaofeng Hou Weihua Zhou Jiangang Zou |
| author_facet | Xiao Hu Xiao Hu Zhiyong Qian Fengwei Zou Siyuan Xue Xinwei Zhang Yao Wang Xiaofeng Hou Weihua Zhou Jiangang Zou |
| author_sort | Xiao Hu |
| collection | DOAJ |
| description | BackgroundUsing single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) with phase analysis (PA), we aimed to identify the predictive value of a new contraction pattern in cardiac resynchronization therapy (CRT) response.MethodsLeft ventricular mechanical dyssynchrony (LVMD) was evaluated using SPECT MPI with PA in non-ischemic dilated cardiomyopathy (DCM) patients with left bundle branch block (LBBB) indicated for CRT. CRT super-response was defined as LV ejection fraction (EF) ≥50% or an absolute increase of LVEF >15%. The LV contraction was categorized as the mild dyssynchronous pattern when the phase standard deviation (PSD) ≤ 40.3° and phase histogram bandwidth (PBW) ≤ 111.9°, otherwise it was defined as severe dyssynchronous pattern which was further characterized as U-shaped, heterogeneous or homogenous pattern.ResultsThe final cohort comprised 74 patients, including 32 (43.2%) in mild dyssynchronous group, 17 (23%) in U-shaped group, 19 (25.7%) in heterogeneous group, and 6 (8.1%) in homogenous group. The mild dyssynchronous group had lower PSD and PBW than U-shaped, heterogeneous, and homogenous groups (P < 0.0001). Compared to patients with the heterogeneous pattern, the odds ratios (ORs) with 95% confidence intervals (CIs) for CRT super-response were 10.182(2.43–42.663), 12.8(2.545–64.372), and 2.667(0.327–21.773) for patients with mild dyssynchronous, U-shaped, and homogenous pattern, respectively. After multivariable adjustment, mild dyssynchronous group remained associated with increased CRT super-response (adjusted OR 5.709, 95% CI 1.152–28.293). Kaplan-Meier curves showed that mild dyssynchronous group demonstrated a better long-term prognosis.ConclusionsThe mild dyssynchronous pattern in patients with DCM is associated with an increased CRT super-response and better long-term prognosis. |
| first_indexed | 2024-04-14T05:15:17Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-14T05:15:17Z |
| publishDate | 2022-05-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-3d7f273df67a4dea8c38ed67618adad12022-12-22T02:10:22ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.906467906467A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization TherapyXiao Hu0Xiao Hu1Zhiyong Qian2Fengwei Zou3Siyuan Xue4Xinwei Zhang5Yao Wang6Xiaofeng Hou7Weihua Zhou8Jiangang Zou9Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaMontefiore Medical Center, Bronx, NY, United StatesDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaCollege of Computing, Michigan Technological University, Houghton, MI, United StatesDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaBackgroundUsing single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) with phase analysis (PA), we aimed to identify the predictive value of a new contraction pattern in cardiac resynchronization therapy (CRT) response.MethodsLeft ventricular mechanical dyssynchrony (LVMD) was evaluated using SPECT MPI with PA in non-ischemic dilated cardiomyopathy (DCM) patients with left bundle branch block (LBBB) indicated for CRT. CRT super-response was defined as LV ejection fraction (EF) ≥50% or an absolute increase of LVEF >15%. The LV contraction was categorized as the mild dyssynchronous pattern when the phase standard deviation (PSD) ≤ 40.3° and phase histogram bandwidth (PBW) ≤ 111.9°, otherwise it was defined as severe dyssynchronous pattern which was further characterized as U-shaped, heterogeneous or homogenous pattern.ResultsThe final cohort comprised 74 patients, including 32 (43.2%) in mild dyssynchronous group, 17 (23%) in U-shaped group, 19 (25.7%) in heterogeneous group, and 6 (8.1%) in homogenous group. The mild dyssynchronous group had lower PSD and PBW than U-shaped, heterogeneous, and homogenous groups (P < 0.0001). Compared to patients with the heterogeneous pattern, the odds ratios (ORs) with 95% confidence intervals (CIs) for CRT super-response were 10.182(2.43–42.663), 12.8(2.545–64.372), and 2.667(0.327–21.773) for patients with mild dyssynchronous, U-shaped, and homogenous pattern, respectively. After multivariable adjustment, mild dyssynchronous group remained associated with increased CRT super-response (adjusted OR 5.709, 95% CI 1.152–28.293). Kaplan-Meier curves showed that mild dyssynchronous group demonstrated a better long-term prognosis.ConclusionsThe mild dyssynchronous pattern in patients with DCM is associated with an increased CRT super-response and better long-term prognosis.https://www.frontiersin.org/articles/10.3389/fcvm.2022.906467/fullCRTmild dyssynchronouscontraction patternSPECTsuper-response |
| spellingShingle | Xiao Hu Xiao Hu Zhiyong Qian Fengwei Zou Siyuan Xue Xinwei Zhang Yao Wang Xiaofeng Hou Weihua Zhou Jiangang Zou A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization Therapy Frontiers in Cardiovascular Medicine CRT mild dyssynchronous contraction pattern SPECT super-response |
| title | A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization Therapy |
| title_full | A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization Therapy |
| title_fullStr | A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization Therapy |
| title_full_unstemmed | A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization Therapy |
| title_short | A Mild Dyssynchronous Contraction Pattern Detected by SPECT Myocardial Perfusion Imaging Predicts Super-Response to Cardiac Resynchronization Therapy |
| title_sort | mild dyssynchronous contraction pattern detected by spect myocardial perfusion imaging predicts super response to cardiac resynchronization therapy |
| topic | CRT mild dyssynchronous contraction pattern SPECT super-response |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.906467/full |
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