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Clinical impacts of scar reduction on gated myocardial perfusion SPECT after cardiac resynchronization therapy

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

It had not been reported that myocardial scar shown on gated myocardial perfusion SPECT (GMPS) might reduce after cardiac resynchronization therapy (CRT). In this study, we aim to investigate the clinical impact and characteristic of scar reduction (SR) after CRT.

Methods and Results

Sixty-one heart failure patients following standard indication for CRT received twice GMPS as pre- and post-CRT evaluations. The patients with an absolute reduction of scar ≥ 10% after CRT were classified as the SR group while the rest were classified as the non-SR group. The SR group (N = 22, 36%) showed more improvement on LV function (∆LVEF: 18.1 ± 12.4 vs 9.4 ± 9.9 %, P = 0.007, ∆ESV: − 91.6 ± 52.6 vs − 38.1 ± 46.5 mL, P < 0.001) and dyssynchrony (ΔPSD: − 26.19 ± 18.42 vs − 5.8 ± 23.0°, P < 0.001, Δ BW: − 128.7 ± 82.8 vs − 25.2 ± 109.0°, P < 0.001) than non-SR group (N = 39, 64%). Multivariate logistic regression analysis showed baseline QRSd (95% CI 1.019-1.100, P = 0.006) and pre-CRT Reduced Wall Thickening (RWT) (95% CI 1.016-1.173, P = 0.028) were independent predictors for the development of SR.

Conclusion

More than one third of patients showed SR after CRT who had more post-CRT improvement on LV function and dyssynchrony than those without SR. Wider QRSd and higher RWT before CRT were related to the development of SR after CRT.

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Abbreviations

ACEi:

Angiotensin-converting enzyme inhibitor

ARB:

Angiotensin receptor blockers

BW:

Bandwidth

CRT:

Cardiac resynchronization therapy

ECG:

Electrocardiography

EDV:

End-diastolic volume

ESV:

End-systolic volume

GMPS:

Gated myocardial perfusion SPECT

HF:

Heart failure

HR:

Heart rate

LVEDD:

LV end-diastolic diameter

LVEF:

LV ejection fractions

MRR:

Mechanical reverse remodeling

NYHA:

New York Heart Association

PSD:

Phase standard deviation

QRSd:

QRS duration

ROC:

Receiver operating characteristic

RWT:

Reduced wall thickening

SR:

Scar deduction

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Disclosures

This study was supported by a Grant from the Taiwan Ministry of Science and Technology (Project Number: 107-2314-B-758-001-MY3, PI: Guang-Uei Hung) and Taichung Veterans General Hospital (Project Number: TCVGH-1093103C, TCVGH-1083104C, TCVGH-1073104C, PI: **-Long Huang). This research was also supported in part by a grant from the American Heart Association (Project Number: 17AIREA33700016, PI: Weihua Zhou) and a new faculty startup grant from Michigan Technological University Institute of Computing and Cybersystems (PI: Weihua Zhou). No other potential conflicts of interest relevant to this article exist.

Author information

Author notes

  1. Chi-Yen Wang, Guang-Uei Hung, and Hsu-Chung Lo are listed as the first authors who contributed equally to this work.

Authors and Affiliations

  1. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan

    Chi-Yen Wang MD, Hsu-Chung Lo MD, **-Long Huang MD, PhD & Shih-Ann Chen MD

  2. Institute of Medicine of Chung, Shan Medical University, Taichung, Taiwan

    Chi-Yen Wang MD

  3. Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan

    Guang-Uei Hung MD

  4. Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

    Shih-Chuan Tsai MD

  5. College of Computing, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA

    Zhuo He BS & Weihua Zhou PhD

  6. Department of Cardiology, The First Affiliated Hospital of Nan**g Medical University, Nan**g, China

    **nwei Zhang MD, PhD & Jiangang Zou MD, PhD

  7. Cardiology Division, Asian University Hospital, Taichung, Taiwan

    Kuo-Feng Chiang MD

  8. Center of Biocomputing and Digital Health, Institute of Computing and Cybersystems, and Health Research Institute, Michigan Technological University, Houghton, USA

    Weihua Zhou PhD

  9. Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan

    **-Long Huang MD, PhD

  10. Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    **-Long Huang MD, PhD & Shih-Ann Chen MD

  11. Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Shih-Ann Chen MD

  12. Department of Medical Education, Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan

    **-Long Huang MD, PhD

Authors
  1. Chi-Yen Wang MD
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  2. Guang-Uei Hung MD
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  3. Hsu-Chung Lo MD
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  4. Shih-Chuan Tsai MD
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  5. Zhuo He BS
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  6. **nwei Zhang MD, PhD
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  7. Kuo-Feng Chiang MD
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  8. Jiangang Zou MD, PhD
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  9. Weihua Zhou PhD
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  11. Shih-Ann Chen MD
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Corresponding authors

Correspondence to Jiangang Zou MD, PhD, Weihua Zhou PhD or **-Long Huang MD, PhD.

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Wang, CY., Hung, GU., Lo, HC. et al. Clinical impacts of scar reduction on gated myocardial perfusion SPECT after cardiac resynchronization therapy. J. Nucl. Cardiol. 29, 2571–2579 (2022). https://doi.org/10.1007/s12350-021-02722-7

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  • DOI: https://doi.org/10.1007/s12350-021-02722-7

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