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Cardiovascular: Clinical ScienceClinical Science Posters |
1 UCSF, San Francisco, California
837
Objectives: Cardiac Resynchronization Therapy (CRT) is currently indicated for pts with advanced heart failure (HF) and a wide QRS duration (> 130 ms). However pts with a narrow QRS might have mechanical dyssynchrony and thus benefit from CRT. Equilibrium radionuclide angiogram (ERNA) derived synchrony parameters have been correlated with clinical outcomes in pts requiring CRT. The aim of the study was to assess ERNA derived synchrony parameters in narrow QRS patients with and without HF.
Methods: The study population included 11 pts without HF and 12 pts with advanced HF (EF < 35%). All pts had narrow QRS complex (<130 ms). ERNA derived parameters included LVEF, standard deviation of phase histogram (SD), synchrony (S) (defined as the vector sum of all pixels in a region divided by the sum of all amplitudes, where the phase and amplitude of each pixel define its vector), and entropy (E) (a measure of the flatness of the phase histogram or the randomness of its distribution). We performed a t-test to compare these parameters in the two groups.
Results: SD, S, and E parameters were significantly worse in narrow QRS pts with HF as compared to pts without HF. Furthermore, 25% of HF patients had S and E parameters that have reliably shown improved clinical outcomes in traditional CRT indicated pts.
Conclusions: A significant number of patients with HF and narrow QRS complex have mechanical dyssynchrony as assessed by ERNA. ERNA imaging in pts with advanced HF and narrow QRS can identify those who will benefit from CRT.
Research Support: Philips
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