The Value of Cardiac Sympathetic Activity and Mechanical Dyssynchrony As Cardiac Resynchronization Therapy Response Predictors: Comparison Between Patients with Ischemic and Non-ischemic Heart Failure

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 2022 Jul 14

PMID 35834158

Authors

Anna I Mishkina

Victor V Saushkin

Tariel A Atabekov

Svetlana I Sazonova

Vladimir V Shipulin

Samia Massalha

Roman E Batalov

Sergey V Popov

Konstantin V Zavadovsky

Affiliations

Soon will be listed here.

Abstract

Background: Impaired cardiac sympathetic activity and mechanical dyssynchrony (MD) are associated with poor prognosis in patients with heart failure (HF) after cardiac resynchronization therapy (CRT). The study aims to assess the significance of scintigraphic evaluation of cardiac sympathetic innervation and contractility in predicting response to CRT in patients with ischemic and non-ischemic chronic HF.

Methods And Results: The study includes 58 HF patients, who were referred for CRT. Prior to CRT all patients underwent I-metaiodobenzylguanidine (I-MIBG) imaging and gated myocardial perfusion imaging (MPI) using a cadmium-zinc-telluride (CZT) SPECT/CT device. At a one-year follow-up post-CRT, the delayed heart-to-mediastinum I-MIBG uptake ratio was an independent predictor of CRT response in non-ischemic HF patients (OR 1.469; 95% CI 1.076-2.007, p = .003). In ischemic HF patients the MD index histogram bandwidth (HBW) obtained by CZT-gated MPI had a predictive value (OR 1.06, 95% CI 1.001-1.112, p = .005) to CRT response.

Conclusion: CRT response can be predicted by cardiac I-MIBG scintigraphy, specifically by the heart-to-mediastinum ratio in non-ischemic HF and by the MD index HBW in ischemic HF. These results suggest the value of a potentially useful algorithm to improve outcomes in HF patients who are candidates for CRT.

Citing Articles

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The Value of Stress-Gated Blood Pool SPECT in Predicting Early Postoperative Period Complications in Ischemic Cardiomyopathy Patients: Focus on Mechanical Dyssynchrony.

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