October 22, 2010European Heart JournalOpen Access

Impact of scar burden by single-photon emission computed tomography myocardial perfusion imaging on patient outcomes following cardiac resynchronization therapy

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Why the study?

Does scar burden quantified by SPECT myocardial perfusion imaging predict clinical and echocardiographic outcomes in ischaemic cardiomyopathy patients receiving cardiac resynchronization therapy?

Structured PICO

Does scar burden quantified by SPECT myocardial perfusion imaging predict clinical and echocardiographic outcomes in ischaemic cardiomyopathy patients receiving cardiac resynchronization therapy?

Population

620 NYHA classes III-IV heart failure patients with ejection fraction (EF) ≤ 35% and QRS duration ≥120 ms referred for CRT, including 190 with ischaemic cardiomyopathy (ICM), 380 with non-ICM, and 50 with unsuccessful LV lead implant.

Intervention

Cardiac resynchronization therapy (CRT) in patients with ischaemic cardiomyopathy stratified by scar burden quantified by rest-redistribution Tl(201) single-photon emission computed tomography (SPECT) myocardial perfusion imaging.

Comparator

Non-ischaemic cardiomyopathy (NICM) CRT recipients and patients referred for CRT with unsuccessful LV lead implant.

Outcome

Composite of death, cardiac transplant, or mechanical circulatory supportcomposite

Extensive scar burden in ischaemic cardiomyopathy patients predicts poor clinical and functional outcomes after cardiac resynchronization therapy, highlighting the value of pre-procedural SPECT imaging.

Discussion

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Implication

High scar burden was associated with poor CRT outcomes; hypothesis-generating for SPECT-guided selection.

Cite This Study

Adelstein et al. (2010) studied this question.

synapsesocial.com/papers/6a0f325104e2b0ba896caa9c https://doi.org/10.1093/eurheartj/ehq389

Topics

HFrEF treatment Cardiac device therapy Heart transplantation Heart failure Echocardiography

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Impact of scar burden by single-photon emission computed tomography myocardial perfusion imaging on patient outcomes following cardiac resynchronization therapy

Structured PICO

Discussion

Implication

Cite This Study

Topics

Impact of scar burden by single-photon emission computed tomography myocardial perfusion imaging on patient outcomes following cardiac resynchronization therapy

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider