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SPECT and Cardiac Resynchronization Therapy

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Abstract

Cardiac resynchronization therapy (CRT) has proven benefits in patients with refractory heart failure including improved symptoms, exercise capacity, quality of life, and left ventricular (LV) function, and mortality benefits. At present, CRT is recommended in patients with severe refractory heart failure (New York Heart Association class III or IV), LV ejection fraction ≤ 35%, QRS duration ≥ 120 ms, and sinus rhythm. When selected based on these standard indications, 20% to 40% of patients fail to respond to CRT. Important parameters for predicting CRT response, such as LV mechanical dyssynchrony, myocardial scar, and LV pacing lead position, have been studied using phase analysis of gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). This review aims to describe the role of gated SPECT MPI for the comprehensive assessment of those parameters for selection of patients for CRT.

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Acknowledgments

Ji Chen and Ernest V. Garcia receive royalties from the sale of the Emory Cardiac Toolbox with SyncTool. The terms of this arrangement have been reviewed and approved by Emory University in accordance with its conflict-of-interest practice. The research in phase analysis is supported in part by a NIH/NHLBI-funded research project (1R01HL094438, PI: Ji Chen).

Mark J. Boogers is supported by the Dutch Heart Foundation grant number 2006 T102.

Disclosure

J. Chen: none; M. J. Boogers: none; P. Soman: consultant to GE Healthcare, Astellas; E. V. Garcia: grant from GE Healthcare.

Author information

Authors and Affiliations

  1. Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA

    Ji Chen & Ernest V. Garcia

  2. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands

    Mark J. Boogers

  3. The Interuniversity Cardiology Institute of The Netherlands, Utrecht, The Netherlands

    Mark J. Boogers

  4. Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Prem Soman

  5. Division of Nuclear Cardiology, University of Pittsburgh Medical Center, 200 Lothrop St, Suite A-429, Pittsburgh, PA, 15212, USA

    Prem Soman

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  1. Ji Chen
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  4. Ernest V. Garcia
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Corresponding authors

Correspondence to Ji Chen, Mark J. Boogers, Prem Soman or Ernest V. Garcia.

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Chen, J., Boogers, M.J., Soman, P. et al. SPECT and Cardiac Resynchronization Therapy. Curr Cardiovasc Imaging Rep 4, 199–206 (2011). https://doi.org/10.1007/s12410-011-9075-7

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  • DOI: https://doi.org/10.1007/s12410-011-9075-7

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