Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy
Autor(a) principal: | |
---|---|
Data de Publicação: | 2018 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Journal of Cardiovascular Sciences (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000300264 |
Resumo: | Abstract Background: Approximately 20 to 40% of patients with heart failure do not respond to cardiac resynchronization therapy (CRT). To improve patient selection, phase analysis by myocardial perfusion scintigraphy (GSPECT) was developed. Objectives: To evaluate the clinical and scintigraphic response of patients with heart failure (HF) submitted to CRT using GSPECT. Method: This was an interventional study that included consecutive patients assessed by GSPECT four weeks prior to CRT implantation and six months after it for comparison. These patients also answered the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The categorical variables were compared using Fisher's exact test and chi-square test, whereas Student's t-test was used for numerical variables. The level of statistical significance was set at 5%. The scintigraphic variables analyzed were left ventricular ejection fraction, end-systolic volume, end-diastolic volume, left ventricular mass, standard deviation and bandwidth, as well as QRS duration and the Minnesota Quality of Life Questionnaire score. The presence of mechanical dyssynchrony was defined as standard deviation > 43º. Results: Nine patients were included in the study. After the cardiac resynchronization therapy, there was a significant improvement (p < 0.05) in the end-systolic volume (206 ± 80 mL vs. 158 ± 108 mL), QRS (180 ± 18 ms vs. 120 ± 9 ms), left ventricular mass (248 ± 65 g vs. 193 ± 52 g) and Minnesota Quality of Life Questionnaire score (63 ± 16 vs. 34 ± 20). All patients with scintigraphic criteria of mechanical dyssynchrony showed clinical improvement. Two patients had only electrical dyssynchrony and did not achieve significant clinical improvement, although they showed QRS duration reduction. Conclusion: GSPECT was able to differentiate patients with isolated electrical dyssynchrony from those with associated mechanical dyssynchrony, through the intraventricular dyssynchrony parameters. The cardiac resynchronization therapy is associated with the improvement of both mechanical and electrical dyssynchrony. Pre-implantation GSPECT showed that patients with associated electrical and mechanical dyssynchrony had a better response to cardiac resynchronization therapy than those with isolated electrical dyssynchrony. |
id |
SBC-2_f97b6632baa779533184c64e27b386dc |
---|---|
oai_identifier_str |
oai:scielo:S2359-56472018000300264 |
network_acronym_str |
SBC-2 |
network_name_str |
International Journal of Cardiovascular Sciences (Online) |
repository_id_str |
|
spelling |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization TherapyHeart FailureCardiac Resynchronization TherapyMyocardial Perfusion Imaging / scintigraphyStroke VolumeArtery Coronary Disease / physiopathologyMyocardial InfarctionAbstract Background: Approximately 20 to 40% of patients with heart failure do not respond to cardiac resynchronization therapy (CRT). To improve patient selection, phase analysis by myocardial perfusion scintigraphy (GSPECT) was developed. Objectives: To evaluate the clinical and scintigraphic response of patients with heart failure (HF) submitted to CRT using GSPECT. Method: This was an interventional study that included consecutive patients assessed by GSPECT four weeks prior to CRT implantation and six months after it for comparison. These patients also answered the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The categorical variables were compared using Fisher's exact test and chi-square test, whereas Student's t-test was used for numerical variables. The level of statistical significance was set at 5%. The scintigraphic variables analyzed were left ventricular ejection fraction, end-systolic volume, end-diastolic volume, left ventricular mass, standard deviation and bandwidth, as well as QRS duration and the Minnesota Quality of Life Questionnaire score. The presence of mechanical dyssynchrony was defined as standard deviation > 43º. Results: Nine patients were included in the study. After the cardiac resynchronization therapy, there was a significant improvement (p < 0.05) in the end-systolic volume (206 ± 80 mL vs. 158 ± 108 mL), QRS (180 ± 18 ms vs. 120 ± 9 ms), left ventricular mass (248 ± 65 g vs. 193 ± 52 g) and Minnesota Quality of Life Questionnaire score (63 ± 16 vs. 34 ± 20). All patients with scintigraphic criteria of mechanical dyssynchrony showed clinical improvement. Two patients had only electrical dyssynchrony and did not achieve significant clinical improvement, although they showed QRS duration reduction. Conclusion: GSPECT was able to differentiate patients with isolated electrical dyssynchrony from those with associated mechanical dyssynchrony, through the intraventricular dyssynchrony parameters. The cardiac resynchronization therapy is associated with the improvement of both mechanical and electrical dyssynchrony. Pre-implantation GSPECT showed that patients with associated electrical and mechanical dyssynchrony had a better response to cardiac resynchronization therapy than those with isolated electrical dyssynchrony.Sociedade Brasileira de Cardiologia2018-05-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000300264International Journal of Cardiovascular Sciences v.31 n.3 2018reponame:International Journal of Cardiovascular Sciences (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/2359-4802.20180022info:eu-repo/semantics/openAccessWiefels,Christiane CigagnaNascimento,Erivelton Alessandro doAlves,Christiane RodriguesRibeiro,Fernanda BaptistaFernandes,Fernando de AmorimRibeiro,Mario LuizMesquita,Claudio Tinocoeng2018-05-29T00:00:00Zoai:scielo:S2359-56472018000300264Revistahttp://publicacoes.cardiol.br/portal/ijcshttps://old.scielo.br/oai/scielo-oai.phptailanerodrigues@cardiol.br||revistaijcs@cardiol.br2359-56472359-4802opendoar:2018-05-29T00:00International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy |
title |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy |
spellingShingle |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy Wiefels,Christiane Cigagna Heart Failure Cardiac Resynchronization Therapy Myocardial Perfusion Imaging / scintigraphy Stroke Volume Artery Coronary Disease / physiopathology Myocardial Infarction |
title_short |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy |
title_full |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy |
title_fullStr |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy |
title_full_unstemmed |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy |
title_sort |
Use of GATED-SPECT for Ventricular Desynchronization Evaluation in Patients with Heart Failure Submitted to Cardiac Resynchronization Therapy |
author |
Wiefels,Christiane Cigagna |
author_facet |
Wiefels,Christiane Cigagna Nascimento,Erivelton Alessandro do Alves,Christiane Rodrigues Ribeiro,Fernanda Baptista Fernandes,Fernando de Amorim Ribeiro,Mario Luiz Mesquita,Claudio Tinoco |
author_role |
author |
author2 |
Nascimento,Erivelton Alessandro do Alves,Christiane Rodrigues Ribeiro,Fernanda Baptista Fernandes,Fernando de Amorim Ribeiro,Mario Luiz Mesquita,Claudio Tinoco |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Wiefels,Christiane Cigagna Nascimento,Erivelton Alessandro do Alves,Christiane Rodrigues Ribeiro,Fernanda Baptista Fernandes,Fernando de Amorim Ribeiro,Mario Luiz Mesquita,Claudio Tinoco |
dc.subject.por.fl_str_mv |
Heart Failure Cardiac Resynchronization Therapy Myocardial Perfusion Imaging / scintigraphy Stroke Volume Artery Coronary Disease / physiopathology Myocardial Infarction |
topic |
Heart Failure Cardiac Resynchronization Therapy Myocardial Perfusion Imaging / scintigraphy Stroke Volume Artery Coronary Disease / physiopathology Myocardial Infarction |
description |
Abstract Background: Approximately 20 to 40% of patients with heart failure do not respond to cardiac resynchronization therapy (CRT). To improve patient selection, phase analysis by myocardial perfusion scintigraphy (GSPECT) was developed. Objectives: To evaluate the clinical and scintigraphic response of patients with heart failure (HF) submitted to CRT using GSPECT. Method: This was an interventional study that included consecutive patients assessed by GSPECT four weeks prior to CRT implantation and six months after it for comparison. These patients also answered the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The categorical variables were compared using Fisher's exact test and chi-square test, whereas Student's t-test was used for numerical variables. The level of statistical significance was set at 5%. The scintigraphic variables analyzed were left ventricular ejection fraction, end-systolic volume, end-diastolic volume, left ventricular mass, standard deviation and bandwidth, as well as QRS duration and the Minnesota Quality of Life Questionnaire score. The presence of mechanical dyssynchrony was defined as standard deviation > 43º. Results: Nine patients were included in the study. After the cardiac resynchronization therapy, there was a significant improvement (p < 0.05) in the end-systolic volume (206 ± 80 mL vs. 158 ± 108 mL), QRS (180 ± 18 ms vs. 120 ± 9 ms), left ventricular mass (248 ± 65 g vs. 193 ± 52 g) and Minnesota Quality of Life Questionnaire score (63 ± 16 vs. 34 ± 20). All patients with scintigraphic criteria of mechanical dyssynchrony showed clinical improvement. Two patients had only electrical dyssynchrony and did not achieve significant clinical improvement, although they showed QRS duration reduction. Conclusion: GSPECT was able to differentiate patients with isolated electrical dyssynchrony from those with associated mechanical dyssynchrony, through the intraventricular dyssynchrony parameters. The cardiac resynchronization therapy is associated with the improvement of both mechanical and electrical dyssynchrony. Pre-implantation GSPECT showed that patients with associated electrical and mechanical dyssynchrony had a better response to cardiac resynchronization therapy than those with isolated electrical dyssynchrony. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-05-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000300264 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000300264 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/2359-4802.20180022 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
dc.source.none.fl_str_mv |
International Journal of Cardiovascular Sciences v.31 n.3 2018 reponame:International Journal of Cardiovascular Sciences (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
International Journal of Cardiovascular Sciences (Online) |
collection |
International Journal of Cardiovascular Sciences (Online) |
repository.name.fl_str_mv |
International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
tailanerodrigues@cardiol.br||revistaijcs@cardiol.br |
_version_ |
1754732625182851072 |