Key result
Quantitative gated SPECT predicted response to cardiac resynchronization therapy, with a phase standard deviation >33° showing 86.6% sensitivity and 90% specificity, and a phase histogram bandwidth >153° showing 100% sensitivity and 80% specificity.
Why the study?
Conventional selection criteria are not consistently able to discriminate between responders and non-responders to cardiac resynchronization therapy.
Does quantitative gated SPECT predict response to cardiac resynchronization therapy in patients with advanced congestive heart failure?
Cross-Sectional (n=25)
Single-blind
No
Does quantitative gated SPECT predict response to cardiac resynchronization therapy in patients with advanced congestive heart failure?
Effect estimate: AUC 0.913 for PSD >33° and AUC 0.943 for PHB >153°
p-value: p=<0.001
Quantitative gated SPECT can help refine patient selection for CRT implantation by using PSD and PHB cutoff points to predict response.
Gated SPECT may help predict CRT response; hypothesis-generating and requires prospective validation before clinical use.
Conventional selection criteria are not consistently able to discriminate between responders and non-responders to cardiac resynchronization therapy (CRT). The objective of this study was to evaluate the usefulness of quantitative gated single-photon emission computed tomography (SPECT) in predicting the response to CRT. This prospective cross-sectional study included 25 patients with advanced congestive heart failure who underwent quantitative gated SPECT before and after CRT implantation. Patients with the left ventricular (LV) lead positioned at the latest activation segment away from the scar had a significantly higher chance of responding than those with the lead positioned at a different area. Responders were likely to have a phase standard deviation (PSD) value of >33°, with 86.6% sensitivity and 90% specificity, and a phase histogram bandwidth (PHB) value of >153°, with 100% sensitivity and 80% specificity. Quantitative gated SPECT can help refine patient selection for CRT implantation, using PSD and PHB cutoff points, in addition to guiding the positioning of the LV lead.
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Abdellatif et al. (2023) conducted a cross-sectional in Advanced congestive heart failure (n=25). Quantitative gated myocardial perfusion imaging (SPECT) was evaluated on Response to cardiac resynchronization therapy (≥5% improvement in LVEF and ≥1 NYHA class improvement) (AUC 0.913 for PSD >33° and AUC 0.943 for PHB >153°, p=<0.001). Quantitative gated SPECT predicted response to cardiac resynchronization therapy, with a phase standard deviation >33° showing 86.6% sensitivity and 90% specificity, and a phase histogram bandwidth >153° showing 100% sensitivity and 80% specificity.
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