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Cardiovascular: Clinical ScienceClinical Science Posters |
1 Cardiology/Nuclear Medicine, University of California San Francisco, San Francisco, California
826
Objectives: Right ventricular (RV) systolic function is not considered in the selection of patients for CRT. We studied RV function and synchrony, using novel parameters generated from equilibrium radionuclide angiography (ERNA), in patients undergoing CRT.
Methods: We analyzed ERNA studies done on 36 patients with left ventricular dilated cardiomyopathy prior to CRT and compared them to studies of 14 chemotherapy patients with normal biventricular function. Calculated were RVEF, standard deviation (SD) of RV phase angle (
), RV synchrony (S) - the vector sum of all regional RV amplitudes divided by the scalar sum of amplitudes - and entropy (E) - a measurement of the degree of RV contraction randomness or disorder.
Results: Although each of the 36 patients undergoing CRT had LVEF <35%, they displayed a wide range of RVEF (18% to 62%) with normal RVEF (>45%) in 12. Compared to CRT patients with normal RVEF, those with RV dysfunction also had significant RV dyssynchrony [SD 32+/-18 vs. 57+/-35, S 0.95+/-0.03 vs. 0.89+/-0.9 and E 0.55+/-0.09 vs. 0.63+/-.13] (p<0.05). In addition, CRT patients with normal RVEF demonstrated RV dyssynchrony compared to chemotherapy patients based on increasing entropy [SD 32+/-18 vs. 24+/-21 (p=0.35) and S 0.95+/-0.03 vs. 0.96+/-0.02 (p=0.14), E 0.55+/-0.09 vs. 0.44+/-0.10 (p=0.003)].
Conclusions: RV dyssynchrony is widespread among pre-CRT patients and is evident even in those with preserved RVEF.
Research Support: Philips Inc. - Research Grant
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